Analysis of change in esophageal varices and clinical characteristics in hepatitis B virus-related cirrhosis after antiviral therapy
10.3760/cma.j.cn501113-20220501-00232
- VernacularTitle:乙型肝炎肝硬化抗病毒治疗后食管静脉曲张转归及其临床特征分析
- Author:
Bingqiong WANG
1
;
Xiaoning WU
;
Jialing ZHOU
;
Yameng SUN
;
Tongtong MENG
;
Shuyan CHEN
;
Qiushuang GUAN
;
Zhiying HE
;
Shanshan WU
;
Yuanyuan KONG
;
Xiaojuan OU
;
Jidong JIA
;
Hong YOU
Author Information
1. 首都医科大学附属北京友谊医院肝病中心 国家消化系统疾病临床医学研究中心，北京 100050
- Keywords:
Chronic hepatitis B;
Liver cirrhosis;
Esophageal varices;
Portal hypertension
- From:
Chinese Journal of Hepatology
2022;30(6):591-597
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To clarify the effect and related factors of antiviral therapy on the change of esophageal varices in patients with hepatitis B virus-related cirrhosis.Methods:Fifty-two cases with hepatitis B virus-related cirrhosis who underwent endoscopy before and after antiviral therapy were selected from prospective cohorts. Patients were divided into three groups: no, mild, and moderate-severe based on the degree of esophageal varices. The changes in the severity of esophageal varices in each group were compared after antiviral therapy. Clinical characteristics (platelet, liver and kidney function, liver stiffness, and virological response) of patients with different regressions were analyzed. Measurement data were analyzed by independent sample t-test, one-way ANOVA, Mann-Whitney U test and Kruskal-Wallis H test, and Chi-Square test was used for count data.Results:All patients received entecavir-based antiviral therapy. The median treatment time was 3.1 (2.5-4.4) years. The proportion of patients without esophageal varices increased from 30.8% to 51.9%, the proportion of mild esophageal varices decreased from 40.4% to 30.8%, and the proportion of patients with moderate-to-severe esophageal varices decreased from 28.8% to 17.3% ( χ2=14.067, P=0.001). A total of 40.4% of patients had esophageal varices regression, and 13.5% had esophageal varices progression. The progression rate was significantly higher in patients with moderate-severe esophageal varices than patients with mild and no esophageal varices ( χ2=28.126, P<0.001), and 60.0% of patients with moderate-severe esophageal varices still remained in moderate-severe state after antiviral treatment. Baseline platelet count and 5-year mean change rates were significantly lower in patients with progressive moderate-to-severe esophageal varices than in those without progression (+3.3% vs. +34.1%, Z=7.00, P=0.027). Conclusion:After effective antiviral treatment, 40.4% of patients with hepatitis B virus-related cirrhosis combined with esophageal varices has obtained esophageal varices regression, but those with moderate to severe esophageal varices still have a considerable risk of progression while receiving mono antiviral treatment only. Thrombocytopenia and without significant improving are the clinical signs of progression risk after receiving antiviral treatment.
