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논문 기본 정보

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학술저널
저자정보
Shin Seung Kak (Department of Internal Medicine Gachon University Gil Medical Center Gachon University College of M) Yim Hyung Joon (Department of Internal Medicine Korea University Ansan Hospital Ansan Korea) Kim Jeong Han (Department of Internal Medicine Konkuk University School of Medicine and 4Department of Internal Me) Lee Chan Uk (Department of Internal Medicine Korea University Guro Hospital Seoul Korea) Yeon Jong Eun (Department of Internal Medicine Korea University Guro Hospital Seoul Korea) Suh Sang Jun (Department of Internal Medicine Korea University Ansan Hospital Ansan Korea) Jung Young Kul (Department of Internal Medicine Korea University Ansan Hospital Ansan Korea) Kim Yun Soo (Department of Internal Medicine Gachon University Gil Medical Center Gachon University College of M) Kim Ju Hyun (Department of Internal Medicine Gachon University Gil Medical Center Gachon University College of M) Kwon Oh Sang (Department of Internal Medicine Gachon University Gil Medical Center Gachon University College of M)
저널정보
거트앤리버 발행위원회 Gut and Liver Gut and Liver 제15권 제3호
발행연도
2021.1
수록면
430 - 439 (10page)

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Background/Aims: The clinical significance of partial virological response (PVR) in patients undergoing antiviral therapy is not well known. This study investigated whether PVR after 2 years of entecavir (ETV) therapy is associated with hepatocellular carcinoma (HCC) development in cirrhotic patients. Methods: A total of 472 naive patients with hepatitis B virus (HBV)-associated cirrhosis who were treated with ETV for at least 2 years were retrospectively enrolled. Clinical characteristics, laboratory data, PVR, and noninvasive fibrosis markers (aspartate aminotransferase to platelet ratio and FIB-4 index) at 2 years after ETV commencement were analyzed for HCC risk. Results: After excluding those who developed HCC within 2 years of ETV therapy, 359 patients (mean age, 51±10 years; male 64.3%) were examined. During a median follow-up of 82 months, 80 patients developed HCC. In the univariate analysis, older age (hazard ratio [HR], 1.056; p<0.001), PVR (HR, 2.536; p=0.002), higher aspartate aminotransferase (HR, 1.018; p=0.005), lower albumin level (HR, 0.463; p<0.001), lower platelet count (HR, 0.993; p=0.01), and higher FIB-4 index (HR, 1.141; p<0.001) at 2 years after ETV commencement were risk factors for HCC. In the multivariate analysis, older age (HR, 1.046; 95% confidence interval [CI], 1.022 to 1.072; p<0.001), PVR (HR, 2.358; 95% CI, 1.310 to 4.245; p=0.004), and higher FIB-4 index (HR, 1.103; 95% CI, 1.035 to 1.177; p=0.003) were independent risk factors. Conclusions: PVR and higher FIB-4 index after 2 years of ETV therapy were independent risk factors for HCC. Therefore, efforts to accomplish a complete virological response and reduce the FIB-4 index should be made.
#Partial virological response #Entecavir #Hepatocellular carcinoma #Hepatitis B virus #Liver cirrhosis

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참고문헌 (25)

참고문헌 신청
Chen CJ / 2006 / Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level / JAMA 295:65~73 google schola Kim JH / 2017 / Low-level viremia and the increased risk of hepatocellular carcinoma in patients receiving entecavir treatment / Hepatology 66:335~343 google schola Kim SS / 2014 / Effect of virological response to entecavir on the development of hepatocellular carcinoma in hepatitis B viral cirrhotic patients : comparison between compensated and decompensated cirrhosis / Am J Gastroenterol 109:1223~1233 google schola Terrault N / 2018 / Is low level viremia acceptable during antiviral therapy of patients with HBV infection and decompensated cirrhosis? / Clin Gastroenterol Hepatol 16:1876~1878 google schola European Association for the Study of the Liver / 2017 / EASL 2017clinical practice guidelines on the management of hepatitis B virus infection / J Hepatol 67:370~398 google schola

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