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Risk Assessment of Liver-related Events Using Transient Elastography in Patients With Chronic Hepatitis B Receiving Entecavir

Authors
 Mi Na Kim  ;  Seung Up Kim  ;  Jun Yong Park  ;  Do Young Kim  ;  Kwang-Hyub Han  ;  Chae Yoon Chon  ;  Sang Hoon Ahn 
Citation
 JOURNAL OF CLINICAL GASTROENTEROLOGY, Vol.48(3) : 272-278, 2014 
Journal Title
 JOURNAL OF CLINICAL GASTROENTEROLOGY 
ISSN
 0192-0790 
Issue Date
2014
MeSH
Adult ; Aged ; Antiviral Agents/therapeutic use* ; Area Under Curve ; Biopsy ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/virology ; Chi-Square Distribution ; Elasticity Imaging Techniques* ; Female ; Guanine/analogs & derivatives* ; Guanine/therapeutic use ; Hepatitis B, Chronic/complications ; Hepatitis B, Chronic/diagnosis ; Hepatitis B, Chronic/drug therapy* ; Hepatitis B, Chronic/mortality ; Humans ; Liver/diagnostic imaging ; Liver/drug effects* ; Liver/virology ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/mortality ; Liver Cirrhosis/virology ; Liver Failure/diagnosis ; Liver Failure/mortality ; Liver Failure/virology ; Liver Neoplasms/diagnosis ; Liver Neoplasms/mortality ; Liver Neoplasms/virology ; Male ; Middle Aged ; Multivariate Analysis ; Predictive Value of Tests ; Prospective Studies ; ROC Curve ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; Young Adult
Abstract
GOALS: We investigated whether liver stiffness (LS) values can predict liver-related events (LREs) development in patients with chronic hepatitis B (CHB). BACKGROUND: LS values using transient elastography provides accurate assessment of liver fibrosis in patients with chronic liver disease. METHODS: Between June 2007 and May 2010, a total of 162 patients with CHB who completed 2-year entecavir (ETV) treatment were evaluated. The primary endpoint was LRE development (hepatic decompensation, hepatocellular carcinoma, or liver-related death) during the 2-year ETV treatment. RESULTS: The median age of the patients (99 men, 63 women) was 51 years, and the median LS value was 14.8 kPa. During the 2-year ETV treatment, 15 (9.3%) patients experienced LREs. On univariate analysis, age, the proportion of patients with liver cirrhosis, platelet counts, and baseline LS values were significantly associated with LRE development (all P<0.05). Together with age, multivariate analysis identified baseline LS values as an independent predictor of LRE development (P=0.046; hazard ratio, 1.040; 95% confidence interval, 1.101-1.084). The cutoff LS value maximizing the sum of sensitivity and specificity was 12.0 kPa (area under the receiver operating characteristics curve, 0.736; P=0.003; sensitivity, 93.3%; specificity, 42.2%). In addition, the changes in LS values between baseline and 1-year ETV treatment showed significant correlations with LRE development (P=0.030). CONCLUSIONS: Our data suggest that LS values are predictive of LRE development during 2-year ETV treatment in patients with CHB. The potential role of LS value as a monitoring tool for predicting dynamic changes in the risk of LRE development during long-term ETV treatment should be investigated further.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00004836-201403000-00015&LSLINK=80&D=ovft
DOI
10.1097/MCG.0b013e31829a7247
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Mi Na(김미나)
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
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98183
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