Factors associated with improvement in MELD score after antiviral treatment in patients with chronic hepatitis B

Terry Cheuk Fung Yip, Hye Won Lee, Vincent Wai Sun Wong, Grace Lai Hung Wong, Yee Kit Tse, Grace Chung Yan Lui, Sang Hoon Ahn, Henry Lik Yuen Chan

Research output: Contribution to journalArticle

Abstract

Background and Aims: Improvement in Model for End-Stage Liver Disease (MELD) score during antiviral treatment is associated with reduced hepatic decompensation and death in patients with chronic hepatitis B (CHB)-related cirrhosis. We aimed to identify factors associated with transplant-free survival and on-treatment MELD score improvement. Methods: We identified patients with CHB-related cirrhosis and MELD score ≥ 15 at the start of entecavir and/or tenofovir disoproxil fumarate treatment between 2005 and 2017. The primary endpoint was transplant-free survival at month 6. The secondary endpoints at month 6 were transplant-free survival with ' 5-point improvement in MELD score and transplant-free survival with MELD score ' 15. Results: Of 999 cirrhotic CHB patients, 605 (60.6%) achieved transplant-free survival at month 6. Proportion of transplant-free survival at month 6 stabilized at 10% in patients with high MELD. Patients who achieved transplant-free survival at month 6 were younger, had lower MELD score, lower alanine aminotransferase (ALT), and higher albumin at baseline. Of 605 patients with transplant-free survival, 276 (45.6%) achieved ' 5-point improvement in MELD score; 183 (30.2%) had 1-point to 5-point improvement in MELD score; 146 (24.1%) had no improvement or a worsened MELD score. Also, 321 (53.1%) patients with transplant-free survival had a MELD score ' 15 at month 6. Conclusion: On top of lower MELD score, patients with CHB-related cirrhosis who are younger, have higher albumin, and lower ALT are more likely to achieve transplant-free survival after 6 months of antiviral treatment.

Original languageEnglish
Pages (from-to)1610-1618
Number of pages9
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume35
Issue number9
DOIs
Publication statusPublished - 2020 Sep 1

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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