Seroclearance reduces the incidence of hepatocellular cancer (HCC) compared to virologically suppressed hepatitis B patients

In a retrospective study of patients with chronic hepatitis B on
suppressive treatment with entecavir or tenofovir, the incidence
of HCC was compared between those who cleared the virus
(negative hepatitis B surface antigen) and those on treatment
who did not clear the virus. Patients in Hong Kong who had
been treated for at least six months were included in the study
from 2005 to 2016. Of 20,263 patients on entecavir/tenofovir
17,499 had complete viral suppression and 376 achieved viral
clearance. Median follow up was 4.8 years. Two patients with
seoroclearance developed HCC (0.5 %) compared to 7.8 % of
those who did not have complete viral suppression and 5.6 %
of patients with complete viral suppression but no seoroclearance.

Ref; Yip et al. J Hepatol 2019;70:361-70

Comment: The available nucleoside /nucleotides are very
effective in suppressing hepatitis B, but have a very limited
effect on clearance of the virus. This study shows that clearance
of the virus compared to suppression is associated with a significantly
lower incidence of HCC. With new drugs for hepatitis
B on the horizon, one may hope that a larger proportion of the
patients will achieve seroclearance and decrease the incidence
of HCC.