{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1362825895428704128.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.1111/apt.12344"}},{"identifier":{"@type":"URI","@value":"https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fapt.12344"}},{"identifier":{"@type":"URI","@value":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/apt.12344"}}],"dc:title":[{"@value":"Meta‐analysis: the impact of oral anti‐viral agents on the incidence of hepatocellular carcinoma in chronic hepatitis B"}],"description":[{"type":"abstract","notation":[{"@value":"<jats:title>SUMMARY</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Five oral nucleos(t)ide analogues are available to treat chronic hepatitis B (<jats:styled-content style=\"fixed-case\">CHB</jats:styled-content>). With the availability of newer agents, their efficacy on incidence of hepatocellular carcinoma (<jats:styled-content style=\"fixed-case\">HCC</jats:styled-content>) is not well described.</jats:p></jats:sec><jats:sec><jats:title>Aim</jats:title><jats:p>To determine the efficacy of oral anti‐viral agents in reducing <jats:styled-content style=\"fixed-case\">HCC</jats:styled-content> risk in relationship with other known factors.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Published studies of at least 20 <jats:styled-content style=\"fixed-case\">CHB</jats:styled-content> patients treated with an oral anti‐viral agent and followed for >2 years were analysed for incidence of <jats:styled-content style=\"fixed-case\">HCC</jats:styled-content> per 100 person years follow‐up.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Pooled homogeneous data from six studies showed lamivudine (<jats:styled-content style=\"fixed-case\">LAM</jats:styled-content>) treatment (<jats:italic>n</jats:italic> = 3306) to reduce <jats:styled-content style=\"fixed-case\">HCC</jats:styled-content> risk by 51% compared with no treatment (<jats:italic>n</jats:italic> = 3585) (3.3 vs. 9.7 per 100 person years, <jats:italic>P</jats:italic> < 0.0001). Pooled data from 49 studies (23 with <jats:styled-content style=\"fixed-case\">LAM</jats:styled-content>; 16 with adefovir; and 10 with entecavir, tenofovir or telbivudine) of 10 025 treated patients showed <jats:styled-content style=\"fixed-case\">HCC</jats:styled-content> incidence of 1.3 per 100 person years, independent of the agent used. Patient age >50 years and hepatitis B virus‐<jats:styled-content style=\"fixed-case\">DNA</jats:styled-content> detectability at <jats:styled-content style=\"fixed-case\">HCC</jats:styled-content> diagnosis increased risk of <jats:styled-content style=\"fixed-case\">HCC</jats:styled-content> by twofold with a 10‐fold higher risk among patients with cirrhosis compared with chronic hepatitis. Meta‐regression showed patient age, study location (Eastern vs. Western) and type of study (randomised or not) contributed to heterogeneity.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Lamivudine treatment significantly reduces the incidence of <jats:styled-content style=\"fixed-case\">HCC</jats:styled-content> compared with no treatment. However, <jats:styled-content style=\"fixed-case\">HCC</jats:styled-content> still develops at a rate of 1.3 per 100 patient years in <jats:styled-content style=\"fixed-case\">CHB</jats:styled-content> patients receiving an oral anti‐viral agent. This finding highlights the need for continued <jats:styled-content style=\"fixed-case\">HCC</jats:styled-content> surveillance, particularly in <jats:styled-content style=\"fixed-case\">CHB</jats:styled-content> patients with inadequate viral suppression, older age and cirrhosis.</jats:p></jats:sec>"}]}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1380285529127095060","@type":"Researcher","foaf:name":[{"@value":"A. K. Singal"}],"jpcoar:affiliationName":[{"@value":"Division of Gastroenterology and Hepatology University of Alabama Birmingham AL USA"}]},{"@id":"https://cir.nii.ac.jp/crid/1382825895428704131","@type":"Researcher","foaf:name":[{"@value":"H. Salameh"}],"jpcoar:affiliationName":[{"@value":"Department of Internal Medicine UTMB Galveston TX USA"}]},{"@id":"https://cir.nii.ac.jp/crid/1380579817402247168","@type":"Researcher","foaf:name":[{"@value":"Y.‐F. Kuo"}],"jpcoar:affiliationName":[{"@value":"Department of Geriatrics and Biostatistics UTMB Galveston TX USA"}]},{"@id":"https://cir.nii.ac.jp/crid/1382825895428704129","@type":"Researcher","foaf:name":[{"@value":"R. J. Fontana"}],"jpcoar:affiliationName":[{"@value":"Division of Gastroenterology University of Michigan Ann Arbor MI USA"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"02692813"},{"@type":"EISSN","@value":"13652036"}],"prism:publicationName":[{"@value":"Alimentary Pharmacology & Therapeutics"}],"dc:publisher":[{"@value":"Wiley"}],"prism:publicationDate":"2013-05-28","prism:volume":"38","prism:number":"2","prism:startingPage":"98","prism:endingPage":"106"},"reviewed":"false","dc:rights":["http://onlinelibrary.wiley.com/termsAndConditions#vor"],"url":[{"@id":"https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fapt.12344"},{"@id":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/apt.12344"}],"createdAt":"2013-05-29","modifiedAt":"2023-10-03","relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360002215482011904","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Asia–Pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update"}]},{"@id":"https://cir.nii.ac.jp/crid/1360283695965035264","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Benefits of nucleos(t)ide analog treatments for hepatitis B virus-related cirrhosis"}]},{"@id":"https://cir.nii.ac.jp/crid/1390845713037670144","@type":"Article","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@language":"ja","@value":"II．核酸アナログ薬時代の B型肝発癌抑止"},{"@language":"en","@value":"II. Reduction of hepatocellular carcinoma incidence in nucleos (t) ide analogues era"},{"@value":"核酸アナログ薬時代のB型肝発癌抑止"},{"@language":"ja-Kana","@value":"カクサン アナログヤク ジダイ ノ Bガタ カンハツガン ヨクシ"}]},{"@id":"https://cir.nii.ac.jp/crid/1390857063645588992","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"Switching to Tenofovir Alafenamide Fumarate in Chronic Hepatitis B Patients Who Had Detectable HBV DNA during Treatment with Entecavir"}]}],"dataSourceIdentifier":[{"@type":"CROSSREF","@value":"10.1111/apt.12344"},{"@type":"CROSSREF","@value":"10.1007/s12072-017-9799-9_references_DOI_T4h1NgdK3oSV1lAHYRxlhZuRDOR"},{"@type":"CROSSREF","@value":"10.4254/wjh.v7.i22.2404_references_DOI_T4h1NgdK3oSV1lAHYRxlhZuRDOR"},{"@type":"CROSSREF","@value":"10.2169/naika.107.19_references_DOI_T4h1NgdK3oSV1lAHYRxlhZuRDOR"},{"@type":"CROSSREF","@value":"10.1620/tjem.2022.j084_references_DOI_T4h1NgdK3oSV1lAHYRxlhZuRDOR"}]}