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Subclinical Ascites Does Not Affect the Long-term Prognosis in Hepatitis B Virus-related Cirrhosis Patients Receiving Antivirals

Authors
Yim, Sun YoungLee, Jeong-HoonAhn, HongkeunKim, Seung UpKim, Sang GyuneKim, Young SeokKim, Jeong HanChoe, Won HyeokKim, Tae YeobJung, Young KulSuh, Sang JunSuk, Ki TaeAn, HyungginYim, Hyung JoonSeo, Yeon SeokUm, Soon Ho
Issue Date
Sep-2016
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Keywords
chronic hepatitis B; liver-related mortality; liver cirrhosis; subclinical ascites
Citation
JOURNAL OF CLINICAL GASTROENTEROLOGY, v.50, no.8, pp.676 - 685
Indexed
SCIE
SCOPUS
Journal Title
JOURNAL OF CLINICAL GASTROENTEROLOGY
Volume
50
Number
8
Start Page
676
End Page
685
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/6126
DOI
10.1097/MCG.0000000000000529
ISSN
0192-0790
Abstract
Background and Aims: This study evaluated the clinical significance of subclinical ascites in patients with hepatitis B virus-related cirrhosis treated with lamivudine (LMV) or entecavir (ETV). Methods: This multicenter retrospective study involved 8 hospitals. Patients were classified by degree of ascites: (1) no ascites (no ascites on imaging, no diuretics), (2) subclinical ascites (small amount of ascites on imaging, no diuretics), and (3) clinical ascites (moderate to severe ascites or diuretics). Results: Out of 501 patients, 336 (68%), 51 (10%), and 114 (23%) patients were classified as no-ascites, subclinical ascites, and clinical ascites, respectively. In all, 100 (20%) and 401 (80%) were treated with LMV and ETV, respectively. Over 58+/-24 months of follow-up, 105 patients (21%) developed hepatocellular carcinoma. The cumulative incidence of hepatocellular carcinoma did not differ between LMV-treated and ETV-treated patients (P=0.61); it was higher in the clinical-ascites group than the no-ascites (P=0.054) and subclinical-ascites (P=0.03) groups, but it was comparable between the latter 2 (P=0.225). Forty-five patients (9%) died during follow-up. Survival was significantly shorter in the clinical-ascites group than the other 2 (both P<0.005), but it was comparable between no-ascites and subclinical-ascites groups (P=0.444). Multivariate analysis showed that mortality was significantly associated with prothrombin time [hazard ratio (HR)=2.42; 95% confidence interval (CI), 1.59-3.70], serum albumin (HR=0.54; 95% CI, 0.29-0.99), and presence of clinical ascites (HR=3.58; 95% CI, 1.54-8.30). Conclusions: Subclinical ascites did not affect prognosis in patients with hepatitis B virus-related cirrhosis receiving antiviral treatment.
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1. Basic Science > Department of Biostatistics > 1. Journal Articles
2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles

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Yim, Hyung Joon
Ansan Hospital (Department of Gastroenterology and Hepatology, Ansan Hospital)
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