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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.
Keywords: alanine aminotransferase; chronic hepatitis B; cirrhosis; hepatocellular carcinoma; subcirrhotic liver stiffness.
Copyright © 2022 AGA Institute. Published by Elsevier Inc. All rights reserved. |
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