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The clinical effect of antiviral therapy in patients with hepatitis B virus-related decompensated cirrhosis and undetectable DNA

Authors
 Han Ah Lee  ;  Young-Sun Lee  ;  Young Kul Jung  ;  Ji Hoon Kim  ;  Hyung Joon Yim  ;  Jong Eun Yeon  ;  Yeon Seok Seo  ;  Jae Seung Lee  ;  Hye Won Lee  ;  Beom Kyung Kim  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Seung Up Kim 
Citation
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Vol.38(5) : 716-723, 2023-05 
Journal Title
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
ISSN
 0815-9319 
Issue Date
2023-05
MeSH
Antiviral Agents / pharmacology ; Antiviral Agents / therapeutic use ; Carcinoma, Hepatocellular* / drug therapy ; DNA, Viral ; Hepatitis B virus / genetics ; Hepatitis B* / complications ; Hepatitis B* / drug therapy ; Hepatitis B, Chronic* / complications ; Hepatitis B, Chronic* / drug therapy ; Hepatitis B, Chronic* / epidemiology ; Humans ; Liver Cirrhosis / etiology ; Liver Neoplasms* / diagnosis ; Retrospective Studies
Keywords
DNA detection ; hepatocellular carcinoma ; liver transplantation ; mortality ; treatment
Abstract
Background and aim: Antiviral therapy (AVT) is the mainstay of hepatitis B virus (HBV) management. We investigated whether AVT improves the outcomes of HBV-related decompensated cirrhosis and undetectable HBV-DNA.

Methods: Between 2000 and 2017, treatment-naïve patients with HBV-related decompensated cirrhosis and undetectable HBV-DNA were recruited from two tertiary hospitals. The endpoints included death and hepatocellular carcinoma (HCC).

Results: A total of 429 patients were analyzed (50 and 379 patients in the AVT and non-AVT groups, respectively). Patients in the AVT group were significantly younger and had higher alanine aminotransferase and alpha-fetoprotein levels than those in the non-AVT group (all P < 0.05). During follow-up (median 49.6 months), 98 patients died and 105 developed HCC. The cumulative incidence rates of death (2.0%, 4.1%, and 6.4%, and 4.9%, 7.2%, and 10.2% at 6 months, 1 year, and 2 years, respectively) and HCC (8.6%, 15.8%, and 26.4% vs 1.6%, 7.7%, and 24.4% at 1, 2, and 5 years, respectively) were statistically comparable between the AVT and non-AVT groups (all P > 0.05). Using Cox regression analysis, AVT was not significantly associated with death nor HCC (all P > 0.05). Similar results were observed after balancing baseline characteristics with inverse probability of treatment weighting. In the non-AVT group, the cumulative incidence rates of HBV-DNA detection at 6 months, 1 year, and 2 years were 2.0%, 3.1%, and 6.4%, respectively.

Conclusions: Antiviral therapy did not attenuate the risk of death nor HCC in patients with HBV-related decompensated cirrhosis and undetectable HBV-DNA.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/jgh.16132
DOI
10.1111/jgh.16132
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Jae Seung(이재승) ORCID logo https://orcid.org/0000-0002-2371-0967
Lee, Hye Won(이혜원) ORCID logo https://orcid.org/0000-0002-3552-3560
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/195989
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