Use of tenofovir disoproxil fumarate is associated with a lower risk of hepatocellular carcinoma than entecavir in patients with chronic hepatitis B

In patients with chronic hepatitis B (CHB), entecavir (ETV) and tenofovir disoproxil fumarate (TDF) are equally recommended as first-line treatment by the international guidelines. These two drugs have shown similar short and intermediate clinical outcomes, including virologic, biochemical, and histologic responses. However, there is considerable controversy as to whether ETV and TDF differ in reducing the risk of hepatocellular carcinoma (HCC) in patients with CHB despite many observational studies and meta-analyses being published. In this review, we summarize recent evidence comparing the preventive effects of these two drugs against HCC from the perspective that TDF is associated with a lower risk of HCC compared with ETV in patients with CHB