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Tenofovir Disoproxil: A Preferred Antiviral Treatment for Hepatitis B Virus-related Hepatocellular Carcinoma Post Liver Resection

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Ethan Sulliva
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Tenofovir Disoproxil: A Preferred Antiviral Treatment for Hepatitis B Virus-related Hepatocellular Carcinoma Post Liver Resection

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A recent study published in JAMA Network Open has shed new light on the effectiveness of antiviral treatments for patients with hepatitis B virus-related hepatocellular carcinoma (HCC) who have undergone liver resection. The study compared the efficacy of two drugs, tenofovir disoproxil and entecavir, in improving overall and recurrence-free survival rates among these patients. The results indicate that tenofovir disoproxil may provide better long-term overall and recurrence-free survival rates than entecavir, making it a preferred choice for long-term antiviral treatment in these cases.

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The Study

The study aimed to evaluate the impact of tenofovir disoproxil and entecavir on survival rates among patients with HBV-related HCC who had undergone liver resection. This research is crucial as hepatitis B virus (HBV) is a significant risk factor for hepatocellular carcinoma (HCC), the most common type of primary liver cancer. Following liver resection, antiviral therapy is a standard procedure to prevent recurrence of the disease.

The results of the study demonstrated that tenofovir disoproxil was associated with improved long-term overall and recurrence-free survival rates when compared to entecavir. This suggests that tenofovir disoproxil could be considered the preferred long-term antiviral treatment for these patients.

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SWITE Study Protocol

Building on the above findings, the SWITE study protocol further aims to compare the efficacy of maintaining entecavir (ETV) and switching to tenofovir disoproxil (TDF) on HCC recurrence risk and survival in patients with prolonged ETV therapy before surgery. This is a prospective, randomized, controlled, single-center study with two parallel groups of patients with HBV-related HCC.

The primary endpoint of this study is 3-year recurrence free survival (RFS), with the secondary endpoint being 3-year overall survival (OS) after curative surgery of HCC. Safety events will be diligently recorded throughout the study. The study protocol aligns with the ethical guidelines of the 1975 Declaration of Helsinki and was registered with chictr.org.cn. Informed consent will be obtained from all participants.

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Implications of the Findings

The implications of these findings are significant for the treatment of patients with HBV-related HCC who have undergone liver resection. The results suggest that tenofovir disoproxil could be the preferred long-term antiviral treatment for improving overall and recurrence-free survival rates. Further, the ongoing SWITE study will provide more detailed insights into whether maintaining ETV or switching to TDF would be more beneficial for patients with prolonged ETV therapy before surgery.

Overall, the findings underscore the importance of personalized medicine and the need for healthcare providers to carefully consider the choice of antiviral therapy for patients with HBV-related HCC post liver resection. As always, patients should consult with their healthcare provider to discuss the best treatment options based on their unique health circumstances.

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