Entecavir vs Tenofovir in association to HCC prevention

Hi all,

I know of no information that definitively says that tenofovir or entecavir is better at stopping development of liver cancer. They both work the same way, by blocking HBV replication. This reduces hepatic inflammation (a major cancer driver) and also reduces ongoing integration of HBV into the cellular genome (also a cancer driver). Their net antiviral efficacy at the prescribed doses is quite similar, so from a simple mechanistic point of view there is no obvious reason one should be better than the other.

That assessment does not take into account long-term, subtle effects, such as tolerability and patient acceptance differences that may affect how well people stick to the prescribed treatment pattern, or subtle (possibly unknown) side effects that differentially affect their ability to suppress cancer development. Those things take decades to be apparent because the rate of liver cancer development is so slow, and to the limit of my knowledge, has not been observed.

I hope this helps.

John.

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