在 HBV 相关肝硬化的恩替卡韦治疗期间,ALT 与实现亚肝硬化和 HCC 无关
Mi Na Kim 1, Jae Seung Lee 2, Hye Won Lee 2, Beom Kyung Kim 2, Jun Yong Park 2, Do Young Kim 2, Sang Hoon Ahn 2, Se Young Jang 3, Won Young Tak 3, Young-Oh Kweon 3 , 朴秀英 3 , 金承佑 4
隶属关系
隶属关系
1个
大韩民国城南 CHA 大学医学院 CHA Bundang 医疗中心内科消化内科;临床和转化肝病学实验室,韩国城南。
2
韩国首尔延世大学医学院内科;韩国首尔 Severance 医院延世肝脏中心。
3个
韩国大邱庆北国立大学医院内科。
4
韩国首尔延世大学医学院内科;韩国首尔 Severance 医院延世肝脏中心。电子地址:[email protected]。
ALT is not associated with achieving subcirrhotic liver stiffness and HCC during entecavir therapy in HBV-related cirrhosis
Mi Na Kim 1 , Jae Seung Lee 2 , Hye Won Lee 2 , Beom Kyung Kim 2 , Jun Yong Park 2 , Do Young Kim 2 , Sang Hoon Ahn 2 , Se Young Jang 3 , Won Young Tak 3 , Young-Oh Kweon 3 , Soo Young Park 3 , Seung Up Kim 4
Affiliations
Affiliations
1
Division of Gastroenterology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea; Clinical and Translational Hepatology Laboratory, Seongnam, Republic of Korea.
2
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea.
3
Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
4
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea. Electronic address: [email protected].
PMID: 36375797 DOI: 10.1016/j.cgh.2022.10.035
Abstract
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-naïve 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 kilopascals 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, 1 year, and 5 years of ETV were not associated with the probability of achieving subcirrhotic LS at 5 years of ETV or risk of HCC development beyond 5 years of ETV (all P>0.05). Patients achieving subcirrhotic LS at 5 years of ETV 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=0.001).
Conclusions: Baseline and on-treatment ALT levels were not associated with achieving subcirrhotic LS at 5 years of ETV, or risk of HCC development beyond 5 years of ETV in patients with HBV-related cirrhosis. Achieving subcirrhotic LS at 5 years of ETV was independently associated with lower risk of HCC development beyond 5 years of ETV.