Reduced risk of hepatocellular carcinoma by achieving a subcirrhotic liver stiffness through antiviral agents in hepatitis B virus-related advanced fibrosis or cirrhosis

The Korean Transient Elastography Study Group

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background and Aim: A subcirrhotic range of liver stiffness (sc-LS), assessed by transient elastography, is associated with better outcomes in patients with chronic hepatitis B (CHB). We investigated whether the achievement of sc-LS by antiviral therapy (AVT) reduced the risk of developing hepatocellular carcinoma (HCC) in patients with CHB-related advanced fibrosis or cirrhosis. Methods: In total, 209 patients with CHB-related advanced fibrosis or cirrhosis, who received paired transient elastography examinations during AVT between 2007 and 2012, were enrolled. The cut-off LS value for ultrasonographic cirrhosis was defined as 11.6 kPa. Results: The median age of the study population was 51 years, with males predominating (n = 138, 66.0%). The median LS value at enrollment was 14.1 kPa (interquartile range: 9.5–24.1 kPa). After 2 years of AVT, 140 (67.0%) patients achieved sc-LS. During the study period, 28 (13.4%) patients developed HCC after 2 years of AVT. On multivariate analysis, the achievement of sc-LS after AVT was independently associated with a decreased risk of HCC development (hazard ratio [HR] = 0.485, P = 0.047), whereas older age (HR = 1.071) and male gender (HR = 3.704) were independently associated with an increased HCC risk (both P < 0.05). Patients with a cirrhotic range of LS value after 2 years of AVT were at a higher risk of HCC development than those with sc-LS (log-rank test, P = 0.020). Conclusions: The achievement of sc-LS after AVT can reduce the risk of HCC development in patients with CHB, even when advanced fibrosis or cirrhosis is apparent on starting AVT.

Original languageEnglish
Pages (from-to)503-510
Number of pages8
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume33
Issue number2
DOIs
Publication statusPublished - 2018 Feb 1

Fingerprint

Hepatitis B virus
Antiviral Agents
Hepatocellular Carcinoma
Fibrosis
Liver
Chronic Hepatitis B
Elasticity Imaging Techniques
Therapeutics
Multivariate Analysis
Population

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

@article{b2f1557cb0604589b5d5e50c800e7f41,
title = "Reduced risk of hepatocellular carcinoma by achieving a subcirrhotic liver stiffness through antiviral agents in hepatitis B virus-related advanced fibrosis or cirrhosis",
abstract = "Background and Aim: A subcirrhotic range of liver stiffness (sc-LS), assessed by transient elastography, is associated with better outcomes in patients with chronic hepatitis B (CHB). We investigated whether the achievement of sc-LS by antiviral therapy (AVT) reduced the risk of developing hepatocellular carcinoma (HCC) in patients with CHB-related advanced fibrosis or cirrhosis. Methods: In total, 209 patients with CHB-related advanced fibrosis or cirrhosis, who received paired transient elastography examinations during AVT between 2007 and 2012, were enrolled. The cut-off LS value for ultrasonographic cirrhosis was defined as 11.6 kPa. Results: The median age of the study population was 51 years, with males predominating (n = 138, 66.0{\%}). The median LS value at enrollment was 14.1 kPa (interquartile range: 9.5–24.1 kPa). After 2 years of AVT, 140 (67.0{\%}) patients achieved sc-LS. During the study period, 28 (13.4{\%}) patients developed HCC after 2 years of AVT. On multivariate analysis, the achievement of sc-LS after AVT was independently associated with a decreased risk of HCC development (hazard ratio [HR] = 0.485, P = 0.047), whereas older age (HR = 1.071) and male gender (HR = 3.704) were independently associated with an increased HCC risk (both P < 0.05). Patients with a cirrhotic range of LS value after 2 years of AVT were at a higher risk of HCC development than those with sc-LS (log-rank test, P = 0.020). Conclusions: The achievement of sc-LS after AVT can reduce the risk of HCC development in patients with CHB, even when advanced fibrosis or cirrhosis is apparent on starting AVT.",
author = "{The Korean Transient Elastography Study Group} and Kim, {Byung Seok} and Seo, {Yeon Seok} and Kim, {Young Seok} and Lee, {Chang Hyeong} and Lee, {Han Ah} and Um, {Soon Ho} and Yoo, {Jeong Ju} and Kim, {Sang Gyune} and Suh, {Sang Jun} and Jung, {Young Kul} and Ahn, {Sang Hoon} and Han, {Kwang Hyub} and Yim, {Hyung Joon} and Kim, {Seung Up}",
year = "2018",
month = "2",
day = "1",
doi = "10.1111/jgh.13854",
language = "English",
volume = "33",
pages = "503--510",
journal = "Journal of Gastroenterology and Hepatology (Australia)",
issn = "0815-9319",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Reduced risk of hepatocellular carcinoma by achieving a subcirrhotic liver stiffness through antiviral agents in hepatitis B virus-related advanced fibrosis or cirrhosis

AU - The Korean Transient Elastography Study Group

AU - Kim, Byung Seok

AU - Seo, Yeon Seok

AU - Kim, Young Seok

AU - Lee, Chang Hyeong

AU - Lee, Han Ah

AU - Um, Soon Ho

AU - Yoo, Jeong Ju

AU - Kim, Sang Gyune

AU - Suh, Sang Jun

AU - Jung, Young Kul

AU - Ahn, Sang Hoon

AU - Han, Kwang Hyub

AU - Yim, Hyung Joon

AU - Kim, Seung Up

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Background and Aim: A subcirrhotic range of liver stiffness (sc-LS), assessed by transient elastography, is associated with better outcomes in patients with chronic hepatitis B (CHB). We investigated whether the achievement of sc-LS by antiviral therapy (AVT) reduced the risk of developing hepatocellular carcinoma (HCC) in patients with CHB-related advanced fibrosis or cirrhosis. Methods: In total, 209 patients with CHB-related advanced fibrosis or cirrhosis, who received paired transient elastography examinations during AVT between 2007 and 2012, were enrolled. The cut-off LS value for ultrasonographic cirrhosis was defined as 11.6 kPa. Results: The median age of the study population was 51 years, with males predominating (n = 138, 66.0%). The median LS value at enrollment was 14.1 kPa (interquartile range: 9.5–24.1 kPa). After 2 years of AVT, 140 (67.0%) patients achieved sc-LS. During the study period, 28 (13.4%) patients developed HCC after 2 years of AVT. On multivariate analysis, the achievement of sc-LS after AVT was independently associated with a decreased risk of HCC development (hazard ratio [HR] = 0.485, P = 0.047), whereas older age (HR = 1.071) and male gender (HR = 3.704) were independently associated with an increased HCC risk (both P < 0.05). Patients with a cirrhotic range of LS value after 2 years of AVT were at a higher risk of HCC development than those with sc-LS (log-rank test, P = 0.020). Conclusions: The achievement of sc-LS after AVT can reduce the risk of HCC development in patients with CHB, even when advanced fibrosis or cirrhosis is apparent on starting AVT.

AB - Background and Aim: A subcirrhotic range of liver stiffness (sc-LS), assessed by transient elastography, is associated with better outcomes in patients with chronic hepatitis B (CHB). We investigated whether the achievement of sc-LS by antiviral therapy (AVT) reduced the risk of developing hepatocellular carcinoma (HCC) in patients with CHB-related advanced fibrosis or cirrhosis. Methods: In total, 209 patients with CHB-related advanced fibrosis or cirrhosis, who received paired transient elastography examinations during AVT between 2007 and 2012, were enrolled. The cut-off LS value for ultrasonographic cirrhosis was defined as 11.6 kPa. Results: The median age of the study population was 51 years, with males predominating (n = 138, 66.0%). The median LS value at enrollment was 14.1 kPa (interquartile range: 9.5–24.1 kPa). After 2 years of AVT, 140 (67.0%) patients achieved sc-LS. During the study period, 28 (13.4%) patients developed HCC after 2 years of AVT. On multivariate analysis, the achievement of sc-LS after AVT was independently associated with a decreased risk of HCC development (hazard ratio [HR] = 0.485, P = 0.047), whereas older age (HR = 1.071) and male gender (HR = 3.704) were independently associated with an increased HCC risk (both P < 0.05). Patients with a cirrhotic range of LS value after 2 years of AVT were at a higher risk of HCC development than those with sc-LS (log-rank test, P = 0.020). Conclusions: The achievement of sc-LS after AVT can reduce the risk of HCC development in patients with CHB, even when advanced fibrosis or cirrhosis is apparent on starting AVT.

UR - http://www.scopus.com/inward/record.url?scp=85041040494&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85041040494&partnerID=8YFLogxK

U2 - 10.1111/jgh.13854

DO - 10.1111/jgh.13854

M3 - Article

C2 - 28666070

AN - SCOPUS:85041040494

VL - 33

SP - 503

EP - 510

JO - Journal of Gastroenterology and Hepatology (Australia)

JF - Journal of Gastroenterology and Hepatology (Australia)

SN - 0815-9319

IS - 2

ER -