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Long-term outcomes of chronic hepatitis B virus infection in the era of antiviral therapy in Korea

Authors
 Yoon Hea Park  ;  Beom Kyung Kim  ;  Ja Kyung Kim  ;  Hyeon Chang Kim  ;  Do Young Kim  ;  Jun Yong Park  ;  Kwang-Hyub Han  ;  Seung Up Kim  ;  Seung Hwan Shin  ;  Kyu Yeon Hahn  ;  Sang Hoon Ahn 
Citation
 Journal of Gastroenterology and Hepatology, Vol.29(5) : 1005-1011, 2014 
Journal Title
 Journal of Gastroenterology and Hepatology 
ISSN
 0815-9319 
Issue Date
2014
Abstract
BACKGROUND AND AIMS: Chronic hepatitis B (CHB) can progress to cirrhosis, hepatocellular carcinoma (HCC), and ultimately liver-related deaths. Recently, owing to potent antiviral therapy with minimal side-effects, sustained suppression of hepatitis B virus replication can be achieved, thereby preventing such complications. We aimed to reappraise clinical courses regarding disease progression in the era of antiviral therapy. METHODS: Between 2001 and 2005, treatment-naïve Korean CHB patients without cirrhosis were enrolled and followed up for at least 5 years. During follow up, antiviral therapy was commenced according to Korean Association for the Study of the Liver guidelines, if eligible, and ultrasonography and laboratory and clinical assessment were performed regularly. Primary end-points were development of cirrhosis, hepatic decompensation, HCC, or liver-related deaths. RESULTS: Of 360 patients, 323 (89.7%) received antiviral therapy such as lamivudine (70.6%), entecavir (8.7%), or telbivudine (6.5%). During follow up, cirrhosis developed in 29 (8.1%), hepatic decompensation in 4 (1.1%), and HCC in 15 (4.2%) patients. Annual incidences of cirrhosis, hepatic decompensation, and HCC were 1.05%, 0.14%, and 0.53% per person-year, respectively. Age was an independent predictor for developing cirrhosis (hazard ratio [HR] 1.075, 95% confidence interval [CI] 1.037-1.116; P < 0.001), whereas age (HR 1.060, 95% CI 1.012-1.111; P = 0.014) and cirrhosis (HR 17.470, 95% CI 5.081-60.063; P < 0.001) were those for developing HCC. CONCLUSIONS: In the era of antiviral therapy, overall clinical courses have been much improved since introduction of lamivudine in 1999. However, patients with older age or cirrhosis are still subject to HCC development despite appropriate antiviral therapy, necessitating cautious surveillance.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/jgh.12478/abstract
DOI
10.1111/jgh.12478
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김도영(Kim, Do Young)
김범경(Kim, Beom Kyung) ORCID logo https://orcid.org/0000-0002-5363-2496
김승업(Kim, Seung Up) ORCID logo https://orcid.org/0000-0002-9658-8050
김자경(Kim, Ja Kyung) ORCID logo https://orcid.org/0000-0001-5025-6846
김현창(Kim, Hyeon Chang) ORCID logo https://orcid.org/0000-0001-7867-1240
박윤혜(Park, Yoon Hea)
박준용(Park, Jun Yong) ORCID logo https://orcid.org/0000-0001-6324-2224
신승환(Shin, Seung Hwan)
안상훈(Ahn, Sang Hoon) ORCID logo https://orcid.org/0000-0002-3629-4624
한광협(Han, Kwang-Hyub) ORCID logo https://orcid.org/0000-0003-3960-6539
한규연(Hahn, Kyu Yeon)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98939
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