Tenofovir use is associated with a decreased risk of hepatocellular carcinoma among men with HIV irrespective of coinfection status
Background & Aims: Tenofovir is recommended as part of the first-line antiretroviral therapy (ART) to treat people living with HIV (PLWH) with HBV coinfection. However, the effects of tenofovir-containing ART on hepatocellular carcinoma (HCC) risk among PLWH with/without chronic hepatitis vi...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | JHEP Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589555922002063 |
| _version_ | 1828005222392266752 |
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| author | Mei-Hsuan Lee Ping-Feng Wu Tzu-I Chen Chi Chan Hsi-Hsun Lin Yi-Hsiang Huang Hsuan-Yu Chen Yi-Tsung Lin Chien-Jen Chen |
| author_facet | Mei-Hsuan Lee Ping-Feng Wu Tzu-I Chen Chi Chan Hsi-Hsun Lin Yi-Hsiang Huang Hsuan-Yu Chen Yi-Tsung Lin Chien-Jen Chen |
| author_sort | Mei-Hsuan Lee |
| collection | DOAJ |
| description | Background & Aims: Tenofovir is recommended as part of the first-line antiretroviral therapy (ART) to treat people living with HIV (PLWH) with HBV coinfection. However, the effects of tenofovir-containing ART on hepatocellular carcinoma (HCC) risk among PLWH with/without chronic hepatitis virus infections remain unclear. Methods: This study included 23,838 PLWH. All of them were males aged ≥20 years and followed prospectively during 2000–2017. Four major nationwide registries – the Human Immunodeficiency Virus surveillance database, Taiwan Cancer Registry, Death Certification System, and National Health Insurance Database – were applied to define ART and comorbidities and ascertain newly diagnosed HCC. Tenofovir-containing ART was identified through prescription records. Cox proportional hazards models were used to determine the association of tenofovir use with HCC incidence. Results: HCC incidence was lower among ever users of tenofovir than among never users (24.2 and 85.7 per 100,000 person-years, respectively). Ever users had significantly reduced HCC risk (adjusted hazard ratio 0.20, 95% CI 0.13–0.31). The effect of tenofovir use on reduced risk for HCC consistently favored never users across many prespecified subgroups, including HBV or HCV coinfection (p <0.05). The findings were consistent in subgroups of PLWH diagnosed with HIV before tenofovir’s approval and in those born before the nationwide roll-out of neonatal HBV vaccination. Conclusions: Our findings underscore the need for randomized controlled trials of tenofovir in combination with long-acting injectable ART regimens to assess its safety and efficacy in PLWH, particularly in those with HBV or HCV coinfection. Impact and implications: Tenofovir’s effect on the risk of hepatocellular carcinoma (HCC) among people living with HIV with hepatitis B or C coinfection remains under investigated. This nationwide prospective cohort study, comprising 23,838 men living with HIV, showed that tenofovir-containing antiretroviral therapy was associated with reduced risk of HCC (adjusted relative risk: 0.20, 95% CI 0.13–0.31), which was consistently observed across many prespecified subgroups. The effect of tenofovir use on HCC risk should be further investigated in PLWH, particularly following the development of long-acting injectable ART regimens. |
| first_indexed | 2024-04-10T07:27:44Z |
| format | Article |
| id | doaj.art-9c18d7db8667424387c4faef43740923 |
| institution | Directory Open Access Journal |
| issn | 2589-5559 |
| language | English |
| last_indexed | 2024-04-10T07:27:44Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JHEP Reports |
| spelling | doaj.art-9c18d7db8667424387c4faef437409232023-02-24T04:31:25ZengElsevierJHEP Reports2589-55592023-03-0153100634Tenofovir use is associated with a decreased risk of hepatocellular carcinoma among men with HIV irrespective of coinfection statusMei-Hsuan Lee0Ping-Feng Wu1Tzu-I Chen2Chi Chan3Hsi-Hsun Lin4Yi-Hsiang Huang5Hsuan-Yu Chen6Yi-Tsung Lin7Chien-Jen Chen8Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Corresponding author. Address: Institute of Clinical Medicine, National Yang Ming Chiao Tung University, 155 Li-Nong Street, Section 2, Peitou, Taipei 112, Taiwan; Tel.: +886-2-2826-7248, fax: +886-2-2820-5699Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Faculty of Medicine, Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, TaiwanGraduate Institute of Business Administration, College of Management, Fu Jen Catholic University, New Taipei City, TaiwanInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, TaiwanInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, TaiwanInstitute of Statistical Science, Academia Sinica, Taipei, TaiwanDivision of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Emergency and Critical Care Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanGenomics Research Center, Academia Sinica, Taipei, TaiwanBackground & Aims: Tenofovir is recommended as part of the first-line antiretroviral therapy (ART) to treat people living with HIV (PLWH) with HBV coinfection. However, the effects of tenofovir-containing ART on hepatocellular carcinoma (HCC) risk among PLWH with/without chronic hepatitis virus infections remain unclear. Methods: This study included 23,838 PLWH. All of them were males aged ≥20 years and followed prospectively during 2000–2017. Four major nationwide registries – the Human Immunodeficiency Virus surveillance database, Taiwan Cancer Registry, Death Certification System, and National Health Insurance Database – were applied to define ART and comorbidities and ascertain newly diagnosed HCC. Tenofovir-containing ART was identified through prescription records. Cox proportional hazards models were used to determine the association of tenofovir use with HCC incidence. Results: HCC incidence was lower among ever users of tenofovir than among never users (24.2 and 85.7 per 100,000 person-years, respectively). Ever users had significantly reduced HCC risk (adjusted hazard ratio 0.20, 95% CI 0.13–0.31). The effect of tenofovir use on reduced risk for HCC consistently favored never users across many prespecified subgroups, including HBV or HCV coinfection (p <0.05). The findings were consistent in subgroups of PLWH diagnosed with HIV before tenofovir’s approval and in those born before the nationwide roll-out of neonatal HBV vaccination. Conclusions: Our findings underscore the need for randomized controlled trials of tenofovir in combination with long-acting injectable ART regimens to assess its safety and efficacy in PLWH, particularly in those with HBV or HCV coinfection. Impact and implications: Tenofovir’s effect on the risk of hepatocellular carcinoma (HCC) among people living with HIV with hepatitis B or C coinfection remains under investigated. This nationwide prospective cohort study, comprising 23,838 men living with HIV, showed that tenofovir-containing antiretroviral therapy was associated with reduced risk of HCC (adjusted relative risk: 0.20, 95% CI 0.13–0.31), which was consistently observed across many prespecified subgroups. The effect of tenofovir use on HCC risk should be further investigated in PLWH, particularly following the development of long-acting injectable ART regimens.http://www.sciencedirect.com/science/article/pii/S2589555922002063AIDSchronic hepatitisrisk assessmentnationwide registryprospective study |
| spellingShingle | Mei-Hsuan Lee Ping-Feng Wu Tzu-I Chen Chi Chan Hsi-Hsun Lin Yi-Hsiang Huang Hsuan-Yu Chen Yi-Tsung Lin Chien-Jen Chen Tenofovir use is associated with a decreased risk of hepatocellular carcinoma among men with HIV irrespective of coinfection status JHEP Reports AIDS chronic hepatitis risk assessment nationwide registry prospective study |
| title | Tenofovir use is associated with a decreased risk of hepatocellular carcinoma among men with HIV irrespective of coinfection status |
| title_full | Tenofovir use is associated with a decreased risk of hepatocellular carcinoma among men with HIV irrespective of coinfection status |
| title_fullStr | Tenofovir use is associated with a decreased risk of hepatocellular carcinoma among men with HIV irrespective of coinfection status |
| title_full_unstemmed | Tenofovir use is associated with a decreased risk of hepatocellular carcinoma among men with HIV irrespective of coinfection status |
| title_short | Tenofovir use is associated with a decreased risk of hepatocellular carcinoma among men with HIV irrespective of coinfection status |
| title_sort | tenofovir use is associated with a decreased risk of hepatocellular carcinoma among men with hiv irrespective of coinfection status |
| topic | AIDS chronic hepatitis risk assessment nationwide registry prospective study |
| url | http://www.sciencedirect.com/science/article/pii/S2589555922002063 |
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