期刊
JOURNAL OF INFECTIOUS DISEASES
卷 221, 期 4, 页码 589-597出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiz496
关键词
fibrosis; HBV; liver cancer; M2BPGi; nucleos(t)ide analogs
资金
- Ministry of Science and Technology, Taiwan [MOST 105-2628-B-002-023-MY3, MOST 107-2628-B-002005]
- National Taiwan University Hospital [106-S3472, VN-107-04, VN-108-05, 107-S3816, 108S4254]
- Liver Disease Prevention & Treatment Research Foundation, Taiwan
Background. To investigate serum Mac-2-binding protein glycosylation isomer (M2BPGi) levels in predicting hepatocellular carcinoma (HCC) and mortality at virological remission (VR, HBV DNA <20 IU/mL) following antiviral therapy in chronic hepatitis B (CHB) patients with cirrhosis. Methods. This retrospective cohort study included patients with CHB-related Child-Pugh A cirrhosis undergoing long-term antiviral therapy. Serum M2BPGi levels were quantified and multivariable Cox proportional hazards regression models were used to identify risk predictors for HCC and death. Results. A total of 126 and 145 patients were included in the derivation and validation cohorts, respectively. The mean age was 56, and the mean M2BPGi level was 1.86 cut-off index (COI) in the derivation cohort. After adjustment for confounders, a higher M2BPGi level at VR significantly predicted HCC (hazard ratio [HR]: 1.58, 95% confidence interval [CI]: 1.19-2.10, P=0.002) and death (HR: 2.17, 95% CI: 1.02-4.62, P=0.044). The M2BPGi >= 3 COI significantly increased the risk of HCC and death in the derivation and validation cohorts. Serial M2BPGi levels declined significantly (P=0.0001) in non-HCC patients only, and remained significantly lower than those who developed HCC afterwards (P=0.039). Conclusions. Serum M2BPGi levels at antiviral therapy-induced VR predict HCC development and death in patients with CHB-related Child-Pugh A cirrhosis.
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