Table 5.
Experts' opinions regarding comparison of ETV, TDF, and TAF on reduction of HCC and approaches to solve these controversies
| Author | Year | Opinion | Superiority or equality |
|---|---|---|---|
| Choi etal. [24] | 2019 | Tenofovir treatment was associated with a significantly lower risk of HCC compared with ETV treatment | TDF > ETV |
|
| |||
| Kim etal. [16] | 2019 | HCC and death or OLT was not statistically different between the ETV and TDF groups | ETV = TDF |
|
| |||
| Lee etal. [15] | 2020 | The clinical outcomes in patients with CHB who received TDF or ETV treatment. There was no difference in the intermediate-term risk of HCC and mortality or LT between the two drugs | TDF = ETV |
|
| |||
| Ha etal. [61] | 2020 | TDF was associated with lower HCC (HR 0.31,95% CI, 0.12–0.79; p = 0.014); however, statistical significance was not reached | ETV = TDF |
|
| |||
| Choi etal. [10] | 2021 | Among patients who underwent curative hepatectomy for HBV-related HCC, TDF therapy was associated with a significantly lower risk of HCC recurrence and better overall patient survival compared with ETV therapy | TDF > ETV |
|
| |||
| Lee etal. [48] | 2021 | ETV- and TAF-treated CHB patients have similar risk of developing HCC | ETV=TAF |
|
| |||
| Zhang etal. [12] | 2019 | There is a better effect of tenofovir in reducing HCC incidence than ETV, which indicates tenofovir should be used more widely while treating chronic hepatitis B patients | TDF > ETV |
|
| |||
| Yip etal. [11] | 2020 | TDF was associated with a lower risk of HCC than treatment with ETV | TDF > ETV |
|
| |||
| Hsu etal. [14] | 2020 | TDF and ETV did not significantly differ in the prevention of HCC in patients with CHB | TDF = ETV |
|
| |||
| Tseng etal. [71] | 2020 | No significant difference was detected between TDF and ETV in their association with incident HCC | TDF = ETV |
|
| |||
| Cheung etal. [70] | 2020 | TDF was associated with a lower HCC risk compared with ETV among patients with CHB, particularly cirrhotic patients | TDF > ETV |
|
| |||
| Papatheodoridis et al. [72] | 2020 | In Caucasian patients with CHB, with or without cirrhosis, long-term ETV or TDF monotherapy is associated with similar HCC risk | ETV = TDF |
|
| |||
| Su etal. [73] | 2021 | No difference in the risk of HCC between patients with CHB treated with ETV versus TDF | ETV = TDF |
Approach to solve the controversy: further clinical studies or trials with a larger number of patients and longer follow-up are needed to resolve these controversial issues and to reach a consensus.