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Cited 29 time in webofscience Cited 29 time in scopus
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Prognosis of hepatitis B-related liver cirrhosis in the era of oral nucleos(t)ide analog antiviral agents

Authors
Kim, Chang HaUm, Soon HoSeo, Yeon SeokJung, Jin YongKim, Jin DongYim, Hyung JoonKeum, BoraKim, Yong SikJeen, Yoon TaeLee, Hong SikChun, Hoon JaiKim, Chang DuckRyu, Ho Sang
Issue Date
Oct-2012
Publisher
WILEY
Keywords
hepatitis B-related liver cirrhosis; lamivudine; oral antiviral agent; prognosis
Citation
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, v.27, no.10, pp.1589 - 1595
Indexed
SCIE
SCOPUS
Journal Title
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
Volume
27
Number
10
Start Page
1589
End Page
1595
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/11684
DOI
10.1111/j.1440-1746.2012.07167.x
ISSN
0815-9319
Abstract
Background and Aim: We investigated long-term outcomes and prognostic factors in patients with hepatitis B virus (HBV)-related liver cirrhosis in the era of oral nucleos(t)ide analog antiviral agents. Methods: Between January 1999 and February 2009, a total of 240 consecutive patients who had HBV-related cirrhosis without malignancy were treated with lamivudine and second line nucleos(t)ide analogs. The group of historical controls consisted of 481 consecutive patients with HBV-related cirrhosis who were managed without any antiviral treatment prior to 1999. Results: In 78% of the patients who received antiviral treatment, sustained viral suppression (serum HBV DNA < 105 copies/mL) was achieved during a mean follow-up period of 46 months. The occurrences of death, hepatic decompensation, and hepatocellular carcinoma (HCC) were less frequent in the treated cohort than in untreated historical controls, with the 5-year cumulative incidences being 19.4% versus 43.9% (log-rank P < 0.001), 15.4% versus 45.4% (P = 0.001), and 13.8% versus 23.4% (P = 0.074), respectively. For patients who received antiviral treatment, suboptimal viral suppression (HBV DNA > 105 copies/mL at last follow-up) was an important independent risk factor of death (P < 0.001) and hepatic decompensation (P = 0.019), and was linked to an increased risk of HCC (P = 0.042). Although the ChildPugh grade remained a useful prognostic factor, no significant differences were found between patients with ChildPugh grade B and C cirrhosis at the beginning of antiviral treatment (P = 0.656). Conclusions: Oral antiviral agents have improved the prognosis of patients with HBV-related cirrhosis and affected the prognostic values of factors constituting the ChildPugh system, necessitating a more efficient prognostic system.
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Chun, Hoon Jai
Anam Hospital (Department of Gastroenterology and Hepatology, Anam Hospital)
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