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Early on-treatment change in liver stiffness predicts development of liver-related events in chronic hepatitis B patients receiving antiviral therapy

Authors
 Beom K. Kim  ;  Hyun J. Oh  ;  Jun Y. Park  ;  Do Y. Kim  ;  Sang H. Ahn  ;  Kwang H. Han  ;  Yehyun Park  ;  Eun J. Yoo  ;  Young N. Park  ;  Seung U. Kim 
Citation
 LIVER INTERNATIONAL, Vol.33(2) : 180-189, 2013 
Journal Title
 LIVER INTERNATIONAL 
ISSN
 1478-3223 
Issue Date
2013
MeSH
Adult ; Antiviral Agents/therapeutic use ; Elasticity Imaging Techniques/methods* ; Endpoint Determination ; Female ; Hepatitis B/complications* ; Hepatitis B/drug therapy ; Histological Techniques ; Humans ; Liver/pathology* ; Liver Cirrhosis/classification ; Liver Cirrhosis/diagnosis* ; Liver Cirrhosis/etiology* ; Male ; Middle Aged ; Prognosis ; Republic of Korea ; Statistics, Nonparametric
Keywords
Adult ; Antiviral Agents/therapeutic use ; Elasticity Imaging Techniques/methods* ; Endpoint Determination ; Female ; Hepatitis B/complications* ; Hepatitis B/drug therapy ; Histological Techniques ; Humans ; Liver/pathology* ; Liver Cirrhosis/classification ; Liver Cirrhosis/diagnosis* ; Liver Cirrhosis/etiology* ; Male ; Middle Aged ; Prognosis ; Republic of Korea ; Statistics, Nonparametric
Abstract
BACKGROUNDS/AIMS: Monitoring fibrosis is mandatory for detailed prognostification in patients with chronic liver disease. We developed optimized cut-offs for liver stiffness (LS) values, based on the histological subclassification of cirrhosis, and investigated whether early on-treatment changes in LS values can predict long-term prognosis in patients with hepatitis B virus (HBV)-related advanced liver fibrosis receiving antiviral therapy. METHODS: Between 2005 and 2008, 103 patients with F3 or F4 fibrosis on liver biopsy were enrolled prospectively. Cirrhosis was subclassified into three groups (F4A, F4B and F4C) according to Laennec system. The primary end-point was occurrence of liver-related event (LRE), including decompensation, hepatocellular carcinoma and liver-related death. RESULTS: Suggested LS cut-offs for predicting F4B-FC (vs. F3-F4A) and F4C (vs. F3-F4B) were 11.6 and 18.2 kPa respectively. As proportions of patients with LRE occurrence increased according to histological subclassifications stage F3-4A vs. F4B-4C (7.4% vs. 17.1%) and stage F3-4B vs. F4C (13.8% vs. 18.8%), they also increased according to LS cut-off value of 11.6 kPa (5.9% vs. 23.1%) and 18.2 kPa (9.8% vs. 33.3%) respectively (all P < 0.05). Similarly, according to stratified LS values (<11.6, 11.6-18.2 and ≥18.2 kPa), overall incidence of LREs and each constituent event increased significantly (all P < 0.05). In addition, the observed changes in LS values between baseline and 6 months of follow-up showed significant correlations with LRE development. CONCLUSIONS: Stratified LS values based on Laennec system and dynamic changes in LS values on follow-up may be helpful in assessing risk of LREs in subjects with HBV-related advanced liver fibrosis receiving antiviral therapy.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/liv.12020/abstract
DOI
10.1111/liv.12020
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
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, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Park, Yehyun(박예현) ORCID logo https://orcid.org/0000-0001-8811-0631
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
Oh, Hyun Jung(오현정)
Yoo, Eun Jin(유은진)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86591
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