Entecavir vs Tenofovir in association to HCC prevention

Thank you Thomas Tu for this forum! It is comforting to know I am not alone. Hello everyone
I’m newly diagnosed and my dr wants me to start Entecavir 0.5mg to prevent HCC in the future but I read somewhere that Tenofovir is superior in that aspect
Is this true?

Hi @Lufun,

I am so sorry for such a late response and that your post fell through the cracks. Welcome to the community! This is the newest info I could find on this subject as related to HCC. Again, sorry for the late response, I hope this helps.


Hi @Lufun,
I join @PuallyHBV in apologizing for the late response and also in welcoming you to the platform/forum. To your question, both Entecavir and Tenofovir (TDF, and TAF) are actually the top 3 first in line treatments when it comes to hepatitis B. All three are effective in slowing down the disease progression and preventing further liver damage. Some patients tolerate one better than the other. I don’t think there is a 100% guarantee that taking these antivirals will prevent liver cancer completely. But rather, the assumptions/thoughts and hope are that since these antivirals are good at slowing down the disease progression and limiting the amount of damage done to the liver, then it will help decrease the rate or chances of one developing a liver cancer. That is my understanding and I think someone taking any of these 3 antivirals has about 80% or so chance of not developing HCC. the experts could correct me if I am wrong on this. I will add that any of these 3 treatment is probably better than doing nothing if you meet the treatment guideline.
I hope this helps. Best, Bansah1.

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Hi @lufun,

There have been controversies over this based on the difference in people treated with either entecavir or tenofovir. Because entecavir was released first, we have more data on it and people who have been on it for longer. People on tenofovir are more likely to be more recently diagnosed. This could lead to a difference in observed HCC rates. My understanding is that once these differences are controlled for, then both entecavir and tenofovir are pretty much equal in preventing liver cancer (about 80% reduction in HCC risk).

Happy for other @ScienceExperts or @HealthExperts to correct me or add any additional points.


Thank you both Bansah and Tu for welcoming me to the platform, and sharing your experience’s
I appreciate your responses and it increases my understanding of treatment goals
While we wait for a cure, using available options is better than nothing
Best wishes to everyone in this community

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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.


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Thank you Bansah and John for your support and in depth explanation. I plan to begin therapy and hope to share my experience, my treatment goal is to prevent developing hcc

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