Increasing antiviral treatment uptake improves survival in patients with HBV-related HCC

Hui, Vicki Wing‐Ki; Chan, Stephen L.; Wong, Vincent Wai‐Sun; Liang, Lilian Yan; Yip, Terry Cheuk‐Fung; Lai, Jimmy Shiu Ming; Yuen, Becky Wing‐Yan; Luk, Hester Wing‐Sum; Tse, Yee‐Kit; Lee, Hye Won; Chan, Henry Lik‐Yuen; Wong, Grace Lai–Hung

doi:10.1016/j.jhepr.2020.100152

Cited by 28 publications

(24 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Based on several retrospective cohorts and studies using health databases, the risk of disease progression and incidence of HCC are both reduced by Nuc therapy, especially in patients with cirrhosis [51][52][53][54][55][56]. The tertiary prevention effect of Nucs in patients with HBV-HCC who receive curative tumor treatment is also demonstrated by RCTs, cohort studies, population-based studies, and meta-analysis [21,55,[57][58][59][60][61][62][63][64][65][66] (Table 1). In a RCT of 200 patients with HBV-HCC undergoing surgical resection, those receiving adjuvant adefovir for 5 years had a significantly lower rate of late recurrence than those in the control group (12% vs. 29%, p = 0.002), although rates of early recurrence were comparable [62].…”

Section: Tertiary Prevention For Patients With Hbv-related Hcc Following Curative Therapy: Nuc Therapymentioning

confidence: 99%

Tertiary Prevention of HCC in Chronic Hepatitis B or C Infected Patients

Teng

Liu

Jeng

et al. 2021

Cancers

View full text Add to dashboard Cite

Hepatocellular carcinoma (HCC) ranks as a leading cause of common cancer and cancer-related death. The major etiology of HCC is due to chronic hepatitis virus including HBV and HCV infections. Scheduled HCC surveillance in high risk populations improves the early detection rate and the feasibility of curative treatment. However, high HCC recurrence rate still accounts for the poor prognosis of HCC patients. In this article, we critically review the pathogenesis of viral hepatitis-related hepatocellular carcinoma and the evidence of tertiary prevention efficacy by current available antiviral treatment, and discuss the knowledge gap in viral hepatitis-related HCC tertiary prevention.

show abstract

Section: Tertiary Prevention For Patients With Hbv-related Hcc Following Curative Therapy: Nuc Therapymentioning

confidence: 99%

Tertiary Prevention of HCC in Chronic Hepatitis B or C Infected Patients

Teng

Liu

Jeng

et al. 2021

Cancers

View full text Add to dashboard Cite

show abstract

“…Treatment with Lamivudine alone or in combination with other ANNAs, results in HBV patients being less likely to develop HCC. This was reported in single clinical studies (51) and in a recent systematic review and meta-analysis (52). In summary, along with the prevention of reactivation of HBV in cancer patients, Lamivudine and other ANNAs are useful as preventive therapy to avoid the development of HCC in chronic HBV patients by suppressing the development of chronic cirrhosis.…”

Section: Repurposing Nucleoside/ Nucleotide Antivirals In Cancermentioning

confidence: 79%

“…Finally, an extended 10 year (2007–2017) study was recently described analyzing the trend in antiviral treatment uptake comparing the effect of different ANNAs’ initiation times on survival, before and after hepatocellular carcinoma (HCC) diagnosis ( 51 ). The study included treating HCC patients with Lamivudine, Adefovir dipivoxil, Entecavir, Telbivudine, and Tenofovir.…”

Section: Repurposing Nucleoside/nucleotide Antivirals In Cancermentioning

confidence: 99%

See 1 more Smart Citation

Putative Repurposing of Lamivudine, a Nucleoside/Nucleotide Analogue and Antiretroviral to Improve the Outcome of Cancer and COVID-19 Patients

2021

View full text Add to dashboard Cite

Lamivudine, also widely known as 3TC belongs to a family of nucleotide/nucleoside analogues of cytidine or cytosine that inhibits the Reverse Transcriptase (RT) of retroviruses such as HIV. Lamivudine is currently indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection or for chronic Hepatitis B (HBV) virus infection associated with evidence of hepatitis B viral replication and active liver inflammation. HBV reactivation in patients with HBV infections who receive anticancer chemotherapy can be a life-threatening complication during and after the completion of chemotherapy. Lamivudine is used, as well as other antiretrovirals, to prevent the reactivation of the Hepatitis B virus during and after chemotherapy. In addition, Lamivudine has been shown to sensitize cancer cells to chemotherapy. Lamivudine and other similar analogues also have direct positive effects in the prevention of cancer in hepatitis B or HIV positive patients, independently of chemotherapy or radiotherapy. Recently, it has been proposed that Lamivudine might be also repurposed against SARS-CoV-2 in the context of the COVID-19 pandemic. In this review we first examine recent reports on the re-usage of Lamivudine or 3TC against the SARS-CoV-2, and we present docking evidence carried out in silico suggesting that Lamivudine may bind and possibly work as an inhibitor of the SARS-CoV-2 RdRp RNA polymerase. We also evaluate and propose assessment of repurposing Lamivudine as anti-SARS-CoV-2 and anti-COVID-19 antiviral. Secondly, we summarize the published literature on the use of Lamivudine or (3TC) before or during chemotherapy to prevent reactivation of HBV, and examine reports of enhanced effectiveness of radiotherapy in combination with Lamivudine treatment against the cancerous cells or tissues. We show that the anti-cancer properties of Lamivudine are well established, whereas its putative anti-COVID effect is under investigation. The side effects of lamivudine and the appearance of resistance to 3TC are also discussed.

show abstract

“…Most studies were conducted in Western countries; whether aspirin works as well in Asia where HBV is highly prevalent and the main cause of HCC remains unclear. Furthermore, patients at risk of HCC should be treated with antiviral therapy, and therefore, additional chemopreventive strategy on top may further reduce the risk of HCC in NA-treated CHB patients ( 4 – 6 , 12 ). In this study, we aimed to investigate the impact of aspirin on HCC risk in patients treated with first-line NAs (entecavir, tenofovir disoproxil fumarate, and/or tenofovir alafenamide).…”

Section: Introductionmentioning

confidence: 99%

Aspirin Reduces the Incidence of Hepatocellular Carcinoma in Patients With Chronic Hepatitis B Receiving Oral Nucleos(t)ide Analog

Hui

Yip

Wong

et al. 2021

Clin Transl Gastroenterol

Self Cite

View full text Add to dashboard Cite

INTRODUCTION: Aspirin may reduce the risk of chronic hepatitis B (CHB)-related hepatocellular carcinoma (HCC) in patients receiving antiviral treatment. We aimed to investigate the impact of aspirin on reducing HCC risk in patients treated with first-line oral nucleos(t)ide analogs (NAs; entecavir and/or tenofovir disoproxil fumarate). METHODS: We conducted a territorywide, retrospective cohort study in NA-treated CHB patients between 2000 and 2018 from the electronic healthcare data repository in Hong Kong. Subjects were classified into aspirin users for at least 90 days during NA treatment (aspirin group) or no aspirin or any other antiplatelet use during follow-up period (no aspirin group). Incidence rates of HCC and gastrointestinal bleeding (GIB) in 2 groups with propensity score matching with 1:3 ratio. RESULTS: Of 35,111 NA-treated CHB patients of mean age of 53.0 years and 61.6% men, sixty-nine (4.0%) and 1,488 (4.5%) developed HCC at a median (interquartile range) of 2.7 (1.4–4.8) years and 3.2 (1.8–6.0) years in the aspirin group and no aspirin group, respectively. A duration-dependent association between aspirin and the risk of HCC was observed (subhazard ratio [sHR] 3 months–2 years: 0.65; 95% confidence interval [CI] 0.47–0.92; sHR 2–5 years: 0.63; 95% CI 0.43–0.94; sHR from ≥5 years: 0.41; 95% CI 0.18–0.91). Patients who took aspirin for ≤2 years had significantly higher risk of GIB (sHR: 1.73, 95% CI 1.07–2.79) than those not receiving aspirin. The risk of GIB started declining with the longer use of aspirin and becoming insignificant for ≥5 years' use (sHR: 0.79, 95% CI 0.19–3.21). DISCUSSION: Long-term aspirin use is associated with a lower risk of HCC in a duration-dependent manner in NA-treated CHB patients without a significant increase in the risk of gastrointestinal adverse effects.

show abstract

Increasing antiviral treatment uptake improves survival in patients with HBV-related HCC

Abstract: Antiviral treatment improves survival in patients with chronic hepatitis B-related HCC. The uptake of antiviral treatment in HCC patients was suboptimal in the past (47.3% in 2007), but dramatically improved to 98.3% in 2017.

Cited by 28 publications

References 26 publications

Tertiary Prevention of HCC in Chronic Hepatitis B or C Infected Patients

Tertiary Prevention of HCC in Chronic Hepatitis B or C Infected Patients

Putative Repurposing of Lamivudine, a Nucleoside/Nucleotide Analogue and Antiretroviral to Improve the Outcome of Cancer and COVID-19 Patients

Aspirin Reduces the Incidence of Hepatocellular Carcinoma in Patients With Chronic Hepatitis B Receiving Oral Nucleos(t)ide Analog

Contact Info

Product

Resources

About