期刊
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
卷 21, 期 9, 页码 2278-+出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.cgh.2022.10.035
关键词
Alanine Aminotransferase; Subcirrhotic Liver Stiffness; Hepatocellular Carcinoma; Chronic Hepatitis B; Cirrhosis
In patients with HBV-related cirrhosis, baseline and on-treatment ALT levels during ETV therapy are not associated with achieving subcirrhotic LS or the risk of HCC development. However, achieving subcirrhotic LS at 5 years of ETV therapy is independently associated with a lower risk of HCC development beyond 5 years of ETV therapy.
BACKGROUND & AIMS: We investigated whether baseline and on-treatment alanine aminotransferase (ALT) levels during entecavir (ETV) therapy are associated with achieving subcirrhotic liver stiffness (LS) and hepatocellular carcinoma (HCC) development in patients with hepatitis B virus (HBV)- related cirrhosis.METHODS: We analyzed data from 347 treatment-naive patients with HBV-related cirrhosis, who started ETV between 2006 and 2011 and were followed up for >5 years without developing HCC. The study outcomes were achieving subcirrhotic LS at 5 years of ETV, and risk of HCC development beyond 5 years of ETV. Subcirrhotic LS was defined as <12 kPa by transient elastography.RESULTS: After 5 years of ETV, 227 (65.4%) patients achieved subcirrhotic LS. During a median follow-up of 9.2 years, 49 (14.1%) patients developed HCC beyond 5 years of ETV. ALT levels at baseline, at 1 year of ETV therapy, and 5 years of ETV therapy were not associated with the probability of achieving subcirrhotic LS at 5 years of ETV therapy or risk of HCC development beyond 5 years of ETV therapy (all P > .05). Patients achieving subcirrhotic LS at 5 years of ETV therapy had significantly lower risk of HCC development than those who did not (adjusted hazard ratio, 0.33; 95% confidence interval, 0.17-0.64; P 1/4 .001).CONCLUSIONS: Baseline and on-treatment ALT levels were not associated with achieving subcirrhotic LS at 5 years of ETV therapy or with risk of HCC development beyond 5 years of ETV therapy in patients with HBV-related cirrhosis. Achieving subcirrhotic LS at 5 years of ETV therapy was independently associated with lower risk of HCC development beyond 5 years of ETV therapy.
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