Recompensation of complications in patients with hepatitis B virus-related decompensated cirrhosis treated with entecavir antiviral therapy.
10.3760/cma.j.cn501113-20230324-00126
- VernacularTitle:恩替卡韦抗病毒治疗的乙型肝炎失代偿期肝硬化患者并发症的再代偿
- Author:
Ting ZHANG
1
;
You DENG
1
;
Hai Yan KANG
2
;
Hui Ling XIANG
3
;
Yue Min NAN
4
;
Jin Hua HU
5
;
Qing Hua MENG
6
;
Ji Lian FANG
7
;
Jie XU
8
;
Xiao Ming WANG
9
;
Hong ZHAO
1
;
Calvin Q PAN
1
;
Ji Dong JIA
9
;
Xiao Yuan XU
10
;
Wen XIE
1
Author Information
1. Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
2. The Sixth Department of Infectious Diseases, Shijiazhuang Fifth Hospital, Shijiazhuang 050021, China.
3. Department of Hepatology and Gastroenterology, the Third Central Hospital of Tianjin, Tianjin 300170, China.
4. Department of Traditional and Western Medical Hepatology, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, China.
5. Department of Liver Disease, the Fifth Medical Centre of Chinese PLA General Hospital, Beijing 100071, China.
6. Department of Liver Disease, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China.
7. Beijing Key Laboratory of Liver Diseases, Peking University People's Hospital, Beijing 100044, China.
8. Department of Infectious Diseases, Peking University Third Hospital, Beijing 100191, China.
9. Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
10. Department of Gastroenterology, Peking University First Hospital, Beijing 100034, China.
- Publication Type:Journal Article
- Keywords:
Chronic hepatitis B;
Decompensated cirrhosis;
Recompensation
- MeSH:
Humans;
Hepatitis B virus/genetics*;
Hepatitis B, Chronic/drug therapy*;
Antiviral Agents/adverse effects*;
Esophageal and Gastric Varices/complications*;
Liver Cirrhosis/complications*;
Treatment Outcome;
Gastrointestinal Hemorrhage/complications*;
Hepatitis B/drug therapy*
- From:
Chinese Journal of Hepatology
2023;31(7):692-697
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To analyze the occurrence of recompensation conditions in patients with chronic hepatitis B virus-related decompensated cirrhosis after entecavir antiviral therapy. Methods: Patients with hepatitis B virus-related decompensated cirrhosis with ascites as the initial manifestation were prospectively enrolled. Patients who received entecavir treatment for 120 weeks and were followed up every 24 weeks (including clinical endpoint events, hematological and imaging indicators, and others) were calculated for recompensation rates according to the Baveno VII criteria. Measurement data were compared using the Student t-test or Mann-Whitney U test between groups. Categorical data were compared by the χ (2) test or Fisher's exact probability method between groups. Results: 283 of the 320 enrolled cases completed the 120-week follow-up, and 92.2% (261/283) achieved a virological response (HBV DNA 20 IU/ml). Child-Pugh and MELD scores were significantly improved after treatment (8.33 ± 1.90 vs. 5.77 ± 1.37, t = 12.70, P < 0.001; 13.37 ± 4.44 vs. 10.45 ± 4.58, t = 5.963, P < 0.001). During the 120-week follow-up period, 14 cases died, two received liver transplants, 19 developed hepatocellular cancer, 11 developed gastroesophageal variceal bleeding, and four developed hepatic encephalopathy. 60.4% (171/283) (no decompensation events occurred for 12 months) and 56.2% (159/283) (no decompensation events occurred for 12 months and improved liver function) of the patients had achieved clinical recompensation within 120 weeks. Patients with baseline MELD scores > 15 after active antiviral therapy achieved higher recompensation than patients with baseline MELD scores ≤15 [50/74 (67.6%) vs. 109/209 (52.2%), χ (2) = 5.275, P = 0.029]. Conclusion: Antiviral therapy can significantly improve the prognosis of patients with hepatitis B virus-related decompensated cirrhosis. The majority of patients (56.2%) had achieved recompensation. Patients with severe disease did not have a lower probability of recompensation at baseline than other patients.
