To the Editor Dr Choi and colleagues1 reported striking findings in 2 large-scale retrospective cohorts, which indicated that the risk of hepatocellular carcinoma (HCC) was lower in patients with chronic hepatitis B treated with tenofovir than entecavir. We have some concerns about this article.
First, we suggest that the hospital cohort may fail to validate the nationwide cohorts because the cumulative HCC incidence of each cohort actually presented different trends. We observed in Figure, A that the HCC incidence of the tenofovir group did not increase after 2 years, which mainly leads to the intergroup divergence in the nationwide cohort. In contrast, the HCC incidence of the tenofovir group in the hospital cohort increased almost in parallel with the entecavir group after 2 years (Figure, C). Though the results are similar, these inconsistent scenarios may indicate distinct reasons behind the findings and should be clarified further.
Liu Z, Sun J, Hou J. Lower Risk of Hepatocellular Carcinoma With Tenofovir vs Entecavir in Patients With Chronic Hepatitis B. JAMA Oncol. 2019;5(6):915. doi:10.1001/jamaoncol.2019.0644
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