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Hepatic Decompensation in Cirrhotic Patients Receiving Antiviral Therapy for Chronic Hepatitis B

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dc.contributor.author김도영-
dc.contributor.author김범경-
dc.contributor.author김승업-
dc.contributor.author박준용-
dc.contributor.author안상훈-
dc.contributor.author이혜원-
dc.date.accessioned2021-10-21T00:16:55Z-
dc.date.available2021-10-21T00:16:55Z-
dc.date.issued2021-09-
dc.identifier.issn1542-3565-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/185455-
dc.description.abstractObjectives: It is unclear if anti-hepatitis B virus (HBV) treatment can eliminate incident hepatic decompensation. Here we report the incidence and predictors of hepatic decompensation among cirrhotic patients receiving antiviral therapy for chronic hepatitis B. Methods: This is a post hoc analysis of two prospective HBV cohorts from Hong Kong and South Korea. Patients with liver stiffness measurement (LSM) ≥10 kPa and compensated liver disease at baseline were included. The primary endpoint was incident hepatic decompensation (jaundice or cirrhotic complications) with competing risk analysis. Results: 818 patients (mean age, 54.9 years; 519 male [63.4%]) were included in the final analysis. During a mean follow-up of 58.1 months, 32 (3.9%) patients developed hepatic decompensation, among whom 34% were secondary to HCC. Three (0.4%) patients experienced variceal bleeding alone, 27 (3.3%) had non-bleeding decompensation and 13 (1.6%) had more than 2 decompensating events Baseline LSM, diabetes, alanine aminotransferase, platelet, total bilirubin, albumin, prothrombin time, and eGFR were independent predictors of hepatic decompensation. 30/506 (5.9%) patients fulfilling the Baveno VI criteria (LSM ≥20 kPa and/or platelet count <150ⅹ109/L) and 2/312 (0.6%) patients not fulfilling the criteria developed hepatic decompensation (P < .001). Conclusions: Hepatic decompensation is uncommon but not eliminated in patients receiving antiviral therapy for HBV-related cirrhosis, and only a third of decompensating events are secondary to HCC. The Baveno VI criteria, which was originally designed to detect varices needing treatment, can be effectively applied in this population to identify patients at risk of decompensation.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherW.B. Saunders-
dc.relation.isPartOfCLINICAL GASTROENTEROLOGY AND HEPATOLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHAntiviral Agents / therapeutic use-
dc.subject.MESHCarcinoma, Hepatocellular* / drug therapy-
dc.subject.MESHCarcinoma, Hepatocellular* / epidemiology-
dc.subject.MESHElasticity Imaging Techniques*-
dc.subject.MESHEsophageal and Gastric Varices*-
dc.subject.MESHGastrointestinal Hemorrhage-
dc.subject.MESHHepatitis B, Chronic* / complications-
dc.subject.MESHHepatitis B, Chronic* / drug therapy-
dc.subject.MESHHumans-
dc.subject.MESHLiver Cirrhosis / complications-
dc.subject.MESHLiver Cirrhosis / drug therapy-
dc.subject.MESHLiver Neoplasms* / drug therapy-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHProspective Studies-
dc.titleHepatic Decompensation in Cirrhotic Patients Receiving Antiviral Therapy for Chronic Hepatitis B-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorHye Won Lee-
dc.contributor.googleauthorTerry Cheuk-Fung Yip-
dc.contributor.googleauthorYee-Kit Tse-
dc.contributor.googleauthorGrace Lai-Hung Wong-
dc.contributor.googleauthorBeom Kyung Kim-
dc.contributor.googleauthorSeung Up Kim-
dc.contributor.googleauthorJun Yong Park-
dc.contributor.googleauthorDo Young Kim-
dc.contributor.googleauthorHenry Lik-Yuen Chan-
dc.contributor.googleauthorSang Hoon Ahn-
dc.contributor.googleauthorVincent Wai-Sun Wong-
dc.identifier.doi10.1016/j.cgh.2020.08.064-
dc.contributor.localIdA00385-
dc.contributor.localIdA00487-
dc.contributor.localIdA00654-
dc.contributor.localIdA01675-
dc.contributor.localIdA02226-
dc.contributor.localIdA03318-
dc.relation.journalcodeJ02981-
dc.identifier.eissn1542-7714-
dc.identifier.pmid32889148-
dc.identifier.urlhttps://www.sciencedirect.com/science/article/pii/S1542356520312234-
dc.subject.keywordAntiviral Therapy-
dc.subject.keywordCirrhosis-
dc.subject.keywordCompeting Risk-
dc.subject.keywordDecompensation-
dc.contributor.alternativeNameKim, Do Young-
dc.contributor.affiliatedAuthor김도영-
dc.contributor.affiliatedAuthor김범경-
dc.contributor.affiliatedAuthor김승업-
dc.contributor.affiliatedAuthor박준용-
dc.contributor.affiliatedAuthor안상훈-
dc.contributor.affiliatedAuthor이혜원-
dc.citation.volume19-
dc.citation.number9-
dc.citation.startPage1950-
dc.citation.endPage1958.e7-
dc.identifier.bibliographicCitationCLINICAL GASTROENTEROLOGY AND HEPATOLOGY, Vol.19(9) : 1950-1958.e7, 2021-09-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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