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ALT Is Not Associated With Achieving Subcirrhotic Liver Stiffness and HCC During Entecavir Therapy in HBV-Related Cirrhosis

Authors
 Mi Na Kim  ;  Jae Seung Lee  ;  Hye Won Lee  ;  Beom Kyung Kim  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Se Young Jang  ;  Won Young Tak  ;  Young-Oh Kweon  ;  Soo Young Park  ;  Seung Up Kim 
Citation
 CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, Vol.21(9) : 2278-2287, 2023-08 
Journal Title
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
ISSN
 1542-3565 
Issue Date
2023-08
MeSH
Antiviral Agents ; Carcinoma, Hepatocellular* / complications ; Hepatitis B virus ; Hepatitis B, Chronic* / complications ; Hepatitis B, Chronic* / drug therapy ; Hepatitis B, Chronic* / pathology ; Humans ; Liver Cirrhosis / complications ; Liver Cirrhosis / drug therapy ; Liver Neoplasms* / complications ; Retrospective Studies ; Treatment Outcome
Keywords
Alanine Aminotransferase ; Chronic Hepatitis B ; Cirrhosis ; Hepatocellular Carcinoma ; Subcirrhotic Liver Stiffness
Abstract
Background & aims: We investigated whether baseline and on-treatment alanine aminotransferase (ALT) levels during entecavir (ETV) therapy are associated with achieving subcirrhotic liver stiffness (LS) and hepatocellular carcinoma (HCC) development in patients with hepatitis B virus (HBV)-related cirrhosis.

Methods: We analyzed data from 347 treatment-naïve patients with HBV-related cirrhosis, who started ETV between 2006 and 2011 and were followed up for >5 years without developing HCC. The study outcomes were achieving subcirrhotic LS at 5 years of ETV, and risk of HCC development beyond 5 years of ETV. Subcirrhotic LS was defined as <12 kPa by transient elastography.

Results: After 5 years of ETV, 227 (65.4%) patients achieved subcirrhotic LS. During a median follow-up of 9.2 years, 49 (14.1%) patients developed HCC beyond 5 years of ETV. ALT levels at baseline, at 1 year of ETV therapy, and 5 years of ETV therapy were not associated with the probability of achieving subcirrhotic LS at 5 years of ETV therapy or risk of HCC development beyond 5 years of ETV therapy (all P > .05). Patients achieving subcirrhotic LS at 5 years of ETV therapy had significantly lower risk of HCC development than those who did not (adjusted hazard ratio, 0.33; 95% confidence interval, 0.17-0.64; P = .001).

Conclusions: Baseline and on-treatment ALT levels were not associated with achieving subcirrhotic LS at 5 years of ETV therapy or with risk of HCC development beyond 5 years of ETV therapy in patients with HBV-related cirrhosis. Achieving subcirrhotic LS at 5 years of ETV therapy was independently associated with lower risk of HCC development beyond 5 years of ETV therapy.
Full Text
https://www.sciencedirect.com/science/article/pii/S1542356522010503
DOI
10.1016/j.cgh.2022.10.035
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/22282913/197940
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