Remaining hepatocellular carcinoma risk in chronic hepatitis B patients receiving entecavir/tenofovir in South Korea

Aim We aimed to identify the incidence rate of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients treated with entecavir or tenofovir in South Korea, and to identify predictors of HCC development in these patients. Methods Between January 2007 and December 2015, 582 CHB patients initially received entecavir ( n = 406, 69.8%) or tenofovir ( n = 176, 30.2%) for CHB. Results During a median follow‐up of 57.1 months, HCC developed in 38 (6.5%) of the 582 patients, regardless of antiviral agent type. Entecavir‐ and tenofovir‐treated patients had similar HCC development rates ( P = 0.471). For the 582 patients, 2‐, 4‐, and 6‐year cumulative HCC development rates were 2.6%, 4.4%, and 8.3%, respectively, and the 2‐, 4‐, and 6‐year cumulative HCC development rates of patients with liver cirrhosis were significantly greater than those of patients without liver cirrhosis (6.2%, 9.8%, and 18.4% vs. 0.3%, 1.1%, and 2.2%, respectively; P < 0.001). Older (≥60 years) patients, regardless of the presence of cirrhosis, and cirrhotic patients aged ≥40 years showed significantly higher risk of HCC development compared to others (both P < 0.05). Multivariate analysis showed that an older age (≥50 years; hazard ratio [HR] 5.02, P = 0.009), and the presence of cirrhosis (HR 4.95, P = 0.002) independently predicted HCC development. Conclusions The 6‐year cumulative HCC development rate was 6.5% in CHB patients treated with entecavir or tenofovir. Age ≥50 years and liver cirrhosis were found to predict HCC development in these patients.