Liver cirrhosis, not antiviral therapy, predicts clinical outcome in cohorts with heterogeneous hepatitis B viral status

Mi Na Kim; Seong Gyu Hwang; Beom Kyung Kim; Jun Yong Park; Do Young Kim; Kwang Hyub Han; Seung Up Kim; Sang Hoon Ahn

doi:10.5009/gnl18204

Liver cirrhosis, not antiviral therapy, predicts clinical outcome in cohorts with heterogeneous hepatitis B viral status

Mi Na Kim, Seong Gyu Hwang, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Kwang Hyub Han, Seung Up Kim, Sang Hoon Ahn

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

10 Citations (Scopus)

Abstract

Background/Aims: Antiviral therapy (AVT) reduces the risk of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis B (CHB). This multicenter retrospective study investigated the effects of AVT and hepatitis B virus (HBV)-related factors on the risk of HCC development in a cohort with heterogeneous HBV status. Methods: A total of 1,843 patients with CHB from two institutions were included in this study. Ultrasound and laboratory tests, including the α-fetoprotein test, were conducted regularly to detect HCC development. Results: The mean age of our study population (1,063 men and 780 women) was 49.4 years. Cirrhosis was identified in 617 patients (33.5%). During follow-up (median, 42.5 months), 81 patients developed HCC (1.39% per person-year). A total of 645 patients (35.0%) received ongoing AVT at enrollment. Ongoing AVT was not significantly associated with the risk of HCC development (all p>0.05). HBV-related variables (HBV DNA level, hepatitis B e antigen status, and alanine aminotransferase level) were also not significantly associated with the risk of HCC development (all p>0.05). In contrast, cirrhosis was significantly associated with the risk of HCC development, regardless of adjustment (adjusted hazard ratio=4.098 to 7.020; all p<0.05). Cirrhosis significantly predicted the risk of HCC development in subgroups with and without ongoing AVT at enrollment, regardless of adjustment. Conclusions: Our study showed that cirrhosis, not AVT and HBV-related variables, was associated with HCC development in a cohort of patients with heterogeneous HBV status. Our results may help clinicians apply individualized surveillance strategies according to fibrotic status in patients with CHB.

Original language	English
Pages (from-to)	197-205
Number of pages	9
Journal	Gut and liver
Volume	13
Issue number	2
DOIs	https://doi.org/10.5009/gnl18204
Publication status	Published - 2019 Mar

Bibliographical note

Funding Information:
This study was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning (2016R1A1A1A05005138), and the Ministry of Education, (2015R1D1A1A01058653). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors are grateful to Dong-Su Jang, (Medical Illustrator, Medical Research Support Section, Yonsei University College of Medicine, Seoul, Republic of Korea) for his help with the figures.

Publisher Copyright:
© 2019 Editorial Office of Gut and Liver. All Rights Reserved.

All Science Journal Classification (ASJC) codes

Hepatology
Gastroenterology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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@article{1d8988b4a73147339b451f7fe1b3c698,

title = "Liver cirrhosis, not antiviral therapy, predicts clinical outcome in cohorts with heterogeneous hepatitis B viral status",

abstract = "Background/Aims: Antiviral therapy (AVT) reduces the risk of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis B (CHB). This multicenter retrospective study investigated the effects of AVT and hepatitis B virus (HBV)-related factors on the risk of HCC development in a cohort with heterogeneous HBV status. Methods: A total of 1,843 patients with CHB from two institutions were included in this study. Ultrasound and laboratory tests, including the α-fetoprotein test, were conducted regularly to detect HCC development. Results: The mean age of our study population (1,063 men and 780 women) was 49.4 years. Cirrhosis was identified in 617 patients (33.5%). During follow-up (median, 42.5 months), 81 patients developed HCC (1.39% per person-year). A total of 645 patients (35.0%) received ongoing AVT at enrollment. Ongoing AVT was not significantly associated with the risk of HCC development (all p>0.05). HBV-related variables (HBV DNA level, hepatitis B e antigen status, and alanine aminotransferase level) were also not significantly associated with the risk of HCC development (all p>0.05). In contrast, cirrhosis was significantly associated with the risk of HCC development, regardless of adjustment (adjusted hazard ratio=4.098 to 7.020; all p<0.05). Cirrhosis significantly predicted the risk of HCC development in subgroups with and without ongoing AVT at enrollment, regardless of adjustment. Conclusions: Our study showed that cirrhosis, not AVT and HBV-related variables, was associated with HCC development in a cohort of patients with heterogeneous HBV status. Our results may help clinicians apply individualized surveillance strategies according to fibrotic status in patients with CHB.",

author = "Kim, {Mi Na} and Hwang, {Seong Gyu} and Kim, {Beom Kyung} and Park, {Jun Yong} and Kim, {Do Young} and Han, {Kwang Hyub} and Kim, {Seung Up} and Ahn, {Sang Hoon}",

note = "Funding Information: This study was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning (2016R1A1A1A05005138), and the Ministry of Education, (2015R1D1A1A01058653). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors are grateful to Dong-Su Jang, (Medical Illustrator, Medical Research Support Section, Yonsei University College of Medicine, Seoul, Republic of Korea) for his help with the figures. Publisher Copyright: {\textcopyright} 2019 Editorial Office of Gut and Liver. All Rights Reserved.",

year = "2019",

month = mar,

doi = "10.5009/gnl18204",

language = "English",

volume = "13",

pages = "197--205",

journal = "Gut and Liver",

issn = "1976-2283",

publisher = "Joe Bok Chung",

number = "2",

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T1 - Liver cirrhosis, not antiviral therapy, predicts clinical outcome in cohorts with heterogeneous hepatitis B viral status

AU - Kim, Mi Na

AU - Hwang, Seong Gyu

AU - Kim, Beom Kyung

AU - Park, Jun Yong

AU - Kim, Do Young

AU - Han, Kwang Hyub

AU - Kim, Seung Up

AU - Ahn, Sang Hoon

N1 - Funding Information: This study was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning (2016R1A1A1A05005138), and the Ministry of Education, (2015R1D1A1A01058653). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors are grateful to Dong-Su Jang, (Medical Illustrator, Medical Research Support Section, Yonsei University College of Medicine, Seoul, Republic of Korea) for his help with the figures. Publisher Copyright: © 2019 Editorial Office of Gut and Liver. All Rights Reserved.

PY - 2019/3

Y1 - 2019/3

N2 - Background/Aims: Antiviral therapy (AVT) reduces the risk of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis B (CHB). This multicenter retrospective study investigated the effects of AVT and hepatitis B virus (HBV)-related factors on the risk of HCC development in a cohort with heterogeneous HBV status. Methods: A total of 1,843 patients with CHB from two institutions were included in this study. Ultrasound and laboratory tests, including the α-fetoprotein test, were conducted regularly to detect HCC development. Results: The mean age of our study population (1,063 men and 780 women) was 49.4 years. Cirrhosis was identified in 617 patients (33.5%). During follow-up (median, 42.5 months), 81 patients developed HCC (1.39% per person-year). A total of 645 patients (35.0%) received ongoing AVT at enrollment. Ongoing AVT was not significantly associated with the risk of HCC development (all p>0.05). HBV-related variables (HBV DNA level, hepatitis B e antigen status, and alanine aminotransferase level) were also not significantly associated with the risk of HCC development (all p>0.05). In contrast, cirrhosis was significantly associated with the risk of HCC development, regardless of adjustment (adjusted hazard ratio=4.098 to 7.020; all p<0.05). Cirrhosis significantly predicted the risk of HCC development in subgroups with and without ongoing AVT at enrollment, regardless of adjustment. Conclusions: Our study showed that cirrhosis, not AVT and HBV-related variables, was associated with HCC development in a cohort of patients with heterogeneous HBV status. Our results may help clinicians apply individualized surveillance strategies according to fibrotic status in patients with CHB.

AB - Background/Aims: Antiviral therapy (AVT) reduces the risk of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis B (CHB). This multicenter retrospective study investigated the effects of AVT and hepatitis B virus (HBV)-related factors on the risk of HCC development in a cohort with heterogeneous HBV status. Methods: A total of 1,843 patients with CHB from two institutions were included in this study. Ultrasound and laboratory tests, including the α-fetoprotein test, were conducted regularly to detect HCC development. Results: The mean age of our study population (1,063 men and 780 women) was 49.4 years. Cirrhosis was identified in 617 patients (33.5%). During follow-up (median, 42.5 months), 81 patients developed HCC (1.39% per person-year). A total of 645 patients (35.0%) received ongoing AVT at enrollment. Ongoing AVT was not significantly associated with the risk of HCC development (all p>0.05). HBV-related variables (HBV DNA level, hepatitis B e antigen status, and alanine aminotransferase level) were also not significantly associated with the risk of HCC development (all p>0.05). In contrast, cirrhosis was significantly associated with the risk of HCC development, regardless of adjustment (adjusted hazard ratio=4.098 to 7.020; all p<0.05). Cirrhosis significantly predicted the risk of HCC development in subgroups with and without ongoing AVT at enrollment, regardless of adjustment. Conclusions: Our study showed that cirrhosis, not AVT and HBV-related variables, was associated with HCC development in a cohort of patients with heterogeneous HBV status. Our results may help clinicians apply individualized surveillance strategies according to fibrotic status in patients with CHB.

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JO - Gut and Liver

JF - Gut and Liver

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ER -

Liver cirrhosis, not antiviral therapy, predicts clinical outcome in cohorts with heterogeneous hepatitis B viral status

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

UN SDGs

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