The Prognosis of Hepatitis B-related Liver Cirrhosis in the Era of Oral Nucleos(

StephenW

J Gastroenterol Hepatol. 2012 May 3. doi: 10.1111/j.1440-1746.2012.07167.x. [Epub ahead of print]
The Prognosis of Hepatitis B-related Liver Cirrhosis in the Era of Oral Nucleos(t)ide analogue Antiviral Agents.Kim CH, Um SH, Seo YS, Jung JY, Kim JD, Yim HJ, Keum B, Kim YS, Jeen YT, Lee HS, Chun HJ, Kim CD, Ryu HS.
SourceDepartment of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

Abstract
Background & Aims:   We investigated long-term outcomes and prognostic factors in patients with hepatitis B virus (HBV)-related liver cirrhosis in the era of oral nucleos(t)ide analogue antiviral agents. Methods:  Between January 1999 and February 2009, a total of 240 consecutive patients who had HBV-related cirrhosis without malignancy were treated with lamivudine and second line nucleos(t)ide analogues. The group of historical controls consisted of 481 consecutive patients with HBV-related cirrhosis who were managed without any antiviral treatment prior to 1999. Results:  In 78% of the patients who received antiviral treatment, sustained viral suppression (serum HBV DNA <10(5 ) copies/mL) was achieved during a mean follow-up period of 46 months. The occurrences of death, hepatic decompensation, and hepatocellular carcinoma (HCC) were less frequent in the treated cohort than in untreated historical controls, with the 5-year cumulative incidences being 19.4% vs. 43.9% (log-rank p<0.001), 15.4% vs. 45.4% (p=0.001), and 13.8% vs. 23.4% (p=0.074), respectively. For patients who received antiviral treatment, suboptimal viral suppression (HBV DNA >10(5 ) copies/mL at last follow-up) was an important independent risk factor of death (p<0.001) and hepatic decompensation (p=0.019), and was linked to an increased risk of HCC (p=0.042). Although the Child-Pugh grade remained a useful prognostic factor, no significant differences were found between patients with Child-Pugh grade B and C cirrhosis at the beginning of antiviral treatment (p=0.656).
Conclusions:  Oral antiviral agents have improved the prognosis of patients with HBV-related cirrhosis and affected the prognostic values of factors constituting the Child-Pugh system, necessitating a more efficient prognostic system. © 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.

StephenW

胃肠肝胆病杂志。 2012五月3。 DOI：10.1111/j.1440-1746.2012.07167.x。 [出处提前打印]
B型肝炎相关的肝硬化患者口服核苷（酸）类似物IDE抗病毒药时代的预后。
金通道，庵的SH，徐黏，郑精云，金JD，盐田黄建忠，Keum乙，金黏，Jeen玉堂，李协，春黄建忠，金CD，刘某HS。
源

内科，韩国，韩国汉城大学医学院。
抽象

背景与目的：我们调查长期结果和预后因素的患者与乙型肝炎病毒（HBV）相关肝硬化的口服核苷（酸）IDE类似物抗病毒药物的时代。方法：1999年1月至2009年2月共240例，无恶性HBV相关性肝硬化的治疗与拉米夫定和第二行的核苷（酸）IDE类似物。历史对照组连续的481人在1999年以前没有任何抗病毒治疗管理与HBV相关性肝硬化患者。结果：在接受抗病毒药物治疗的患者的78％，持续的病毒抑制（血清HBV DNA <10（5）拷贝/毫升）在平均随访46个月内实现。死亡，肝功能失代偿，肝细胞癌（HCC）的发生，在处理队列频繁，比未经处理的历史对照，5年累计发生率19.4％与43.9％（对数秩P <0.001）， 15.4％和45.4％（P = 0.001），13.8％和23.4％（P = 0.074），分别。为病人接受抗病毒药物治疗，最理想的病毒抑制（血清HBV DNA> 10（5）拷贝/ mL，最后跟进）是死亡的一个重要的独立危险因素（P <0.001）和肝功能失代偿（P = 0.019），与肝癌（P = 0.042）的风险增加。虽然儿童Pugh分级仍然是一个有用的预后因素，发现与Child-Pugh分级B级和C肝硬化患者在开始抗病毒治疗（P = 0.656）之间无显着性差异。结论：口服抗病毒药物的改善与HBV相关性肝硬化患者的预后及影响因素，构成Child-Pugh分级系统的预测值，需要一个更有效的预测系统。 ©2012  - 胃肠病学和肝病基金会和Blackwell出版亚洲私人有限公司