{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T13:32:30Z","timestamp":1789651950573,"version":"4.0.0"},"reference-count":39,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T00:00:00Z","timestamp":1620691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Tenofovir disoproxil fumarate (TDF) monotherapy is recommended for the treatment of chronic hepatitis B (CHB) patients who are refractory to other drugs. Yet, little data are available for the effectiveness of TDF monotherapy compared with TDF\u2010based combination therapy on the risk of hepatocellular carcinoma (HCC) and death\/transplantation. This nationwide population\u2010based cohort study included 11,289 CHB patients who initiated TDF rescue therapy after failure of preceding treatments between 2012 and 2014 in Korea. The risks of HCC and death\/transplantation were compared between TDF combotherapy (<jats:italic>n\u00a0=<\/jats:italic>\u00a02,499) and TDF monotherapy (<jats:italic>n\u00a0=<\/jats:italic>\u00a08,790) groups. The findings were validated in a hospital cohort of 1,163 CHB patients. In the nationwide cohort, during 44.2\u00a0months of overall treatment duration, 529 patients developed HCC and 190 died or received transplantation. In the 2,499 propensity score\u2010matched pairs, compared with TDF combotherapy, TDF monotherapy showed no significantly different risks of HCC (1.11\/100 person\u2010year [PY] vs. 1.32\/100 PY; HR 1.23, 95% CI 0.95\u22121.60, <jats:italic>p\u00a0=<\/jats:italic>\u00a0.12) and death\/transplant (0.43\/100 PY vs. 0.42\/100 PY; HR 1.04, 95% CI 0.67\u22121.60, <jats:italic>p\u00a0=<\/jats:italic>\u00a0.87). However, in the 469 propensity score\u2010matched pairs of cirrhosis subcohort, TDF monotherapy was associated with a higher risk of HCC than TDF combotherapy (HR 1.46, 95% CI 1.002\u22122.12, <jats:italic>p\u00a0=<\/jats:italic>\u00a0.049). In the validation hospital cohort, TDF monotherapy was not associated with significantly different risks of HCC and death\/transplant in the entire cohort and cirrhosis subcohort. In CHB patients with failure to preceding treatments, TDF monotherapy showed no higher risks of HCC and death\/transplantation compared with TDF combotherapy. However, the comparative effectiveness of rescue TDF monotherapy should be further clarified in cirrhotic patients since the findings were not consistent in the nationwide and hospital cohorts.<\/jats:p>","DOI":"10.1111\/jvh.13530","type":"journal-article","created":{"date-parts":[[2021,5,2]],"date-time":"2021-05-02T02:16:20Z","timestamp":1619921780000},"page":"1150-1159","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Tenofovir disoproxil fumarate on the risk of hepatocellular carcinoma in chronic hepatitis B patients with failure to preceding treatments: A nationwide cohort study"],"prefix":"10.1111","volume":"28","author":[{"given":"Jayoun","family":"Lee","sequence":"first","affiliation":[{"name":"Division for Healthcare Technology Assessment Research National Evidence\u2010based Healthcare Collaborating Agency Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gi\u2010Ae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Kyung Hee University School of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo Jeong","family":"Kim","sequence":"additional","affiliation":[{"name":"Division for Healthcare Technology Assessment Research National Evidence\u2010based Healthcare Collaborating Agency Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songhee","family":"Cho","sequence":"additional","affiliation":[{"name":"Division for Healthcare Technology Assessment Research National Evidence\u2010based Healthcare Collaborating Agency Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Jung","family":"Ko","sequence":"additional","affiliation":[{"name":"Division for Healthcare Technology Assessment Research National Evidence\u2010based Healthcare Collaborating Agency Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1544-577X","authenticated-orcid":false,"given":"Young\u2010Suk","family":"Lim","sequence":"additional","affiliation":[{"name":"Division for Healthcare Technology Assessment Research National Evidence\u2010based Healthcare Collaborating Agency Seoul Korea"},{"name":"Department of Gastroenterology Liver Center Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(18)30056-6"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)61412-X"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32154-2"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)30204-3"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29321"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.1.65"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.11.016"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa033364"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2014.02.033"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28280"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2018.4070"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2013-305517"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2012.11.039"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23327"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26686"},{"key":"e_1_2_10_17_1","unstructured":"WHO.Guidelines for the prevention care and treatment of persons with chronic hepatitis B infection 2015.http:\/\/apps.who.int\/iris\/handle\/10665\/154590. 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