{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T13:55:45Z","timestamp":1792418145012,"version":"4.4.0"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Adherence to antiviral therapy is essential for viral suppression in chronic hepatitis B (CHB), yet its effect on hepatocellular carcinoma (HCC) remains uncertain. We examined the association between nucleos(t)ide analog (NA) adherence and HCC risk, focusing on tenofovir alafenamide (TAF) versus entecavir (ETV). Treatment\u2010na\u00efve adults with CHB initiating TAF or ETV were identified from the Health Insurance Review and Assessment Service, Republic of Korea. Adherence was measured using the medication possession ratio, with high adherence defined as \u2265\u200990%, and the primary outcome was HCC incidence. A total of 28 448 patients were included, of whom 19 001 (66.8%) showed high adherence and 9447 (33.2%) showed low adherence. In the overall cohort, HCC incidence was comparable between the high\u2010 and low\u2010adherence groups (14.89 vs. 13.76 per 1000 person\u2010years; IRR, 1.08; 95% CI, 0.95\u20131.24). Among patients with claims\u2010defined cirrhosis, however, high adherence was associated with lower observed HCC incidence (32.92 vs. 49.59 per 1000 person\u2010years; IRR, 0.66; 95% CI, 0.57\u20130.78), and this association remained significant in multivariable Cox regression (HR, 0.77; 95% CI, 0.66\u20130.90) as well as in IPTW, landmark, and sensitivity analyses. In exploratory regimen\u2010stratified analyses, high\u2010adherence TAF users showed a lower observed cumulative HCC incidence than high\u2010adherence ETV users, whereas no significant difference was observed in the low\u2010adherence group. Logistic regression identified ETV use as a predictor of low adherence (OR, 2.80; 95% CI, 2.65\u20132.96). High adherence to antiviral therapy was associated with lower observed HCC incidence among patients with CHB and claims\u2010defined cirrhosis. Although this association remained evident across multiple analyses, residual confounding, treatment\u2010selection effects, time\u2010related bias, and competing\u2010risk issues cannot be fully excluded.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jmv.71167","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:51:21Z","timestamp":1790603481000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High Treatment Adherence Is Associated With Lower Observed HCC Risk in Patients With Chronic Hepatitis B and Cirrhosis: A Nationwide Claims\u2010Based Cohort Study"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6043-6831","authenticated-orcid":false,"given":"Yoon E.","family":"Shin","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Soon Chun Hyang University Hospital Bucheon Bucheon\u2010si Gyeonggi\u2010do Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9628-421X","authenticated-orcid":false,"given":"Jae Young","family":"Kim","sequence":"additional","affiliation":[{"name":"College of Medicine, Soon Chun Hyang University Cheonan\u2010si Chungcheongnam\u2010do Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7802-0381","authenticated-orcid":false,"given":"Jeong Ju","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology, College of Medicine Soon Chun Hyang University Bucheon\u2010si Gyeonggi\u2010do Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8694-777X","authenticated-orcid":false,"given":"Sang Gyune","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology, College of Medicine Soon Chun Hyang University Bucheon\u2010si Gyeonggi\u2010do Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7113-3623","authenticated-orcid":false,"given":"Young Seok","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology, College of Medicine Soon Chun Hyang University Bucheon\u2010si Gyeonggi\u2010do Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"World Health O. Hepatitis B.2025."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2014.03.048"},{"issue":"9","key":"e_1_2_9_4_1","article-title":"Persistence of Hepatitis B Virus Covalently Closed Circular DNA in Hepatocytes: Molecular Mechanisms and Clinical Significance","volume":"3","author":"Yang H. 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