OBJECTIVE: Entecavir (ETV) is a potent inhibitor of viral replication in chronic hepatitis B and prolonged treatment may result in regression of fibrosis. The aim of this study was to investigate the effect of ETV on disease progression. DESIGN: In a multicentre cohort study, 372 ETV-treated patients were investigated. Clinical events were defined as development of hepatocellular carcinoma (HCC), hepatic decompensation or death. Virological response (VR) was defined as HBV DNA <80 IU/ml. RESULTS: Patients were classified as having chronic hepatitis B without cirrhosis (n=274), compensated cirrhosis (n=89) and decompensated cirrhosis (n=9). The probability of VR was not influenced by severity of liver disease (p=0.62). During a median follow-up of 20 months (IQR 11-32), the probability of developing clinical events was higher for patients with cirrhosis (HR 15.41 (95% CI 3.42 to 69.54), p<0.001). VR was associated with a lower probability of disease progression (HR 0.29 (95% CI 0.08 to 1.00), p=0.05) which remained after correction for established risk factors such as age. The benefit of VR was only significant in patients with cirrhosis (HR 0.22 (95% CI 0.05 to 0.99), p=0.04) and remained after excluding decompensated patients (HR 0.15 (95% CI 0.03 to 0.81), p=0.03). A higher HBV DNA threshold of 2000 IU/ml was not associated with the probability of disease progression (HR 0.20 (95% CI 0.03 to 1.10), p=0.10). CONCLUSION: VR to ETV is associated with a lower probability of disease progression in patients with cirrhosis, even after correction for possible baseline confounders. When using a threshold of 2000 IU/ml, the association between viral replication and disease progression was reduced, suggesting that complete viral suppression is essential for nucleoside/nucleotide analogue treatment, especially in patients with cirrhosis.
OBJECTIVE:Entecavir (ETV) is a potent inhibitor of viral replication in chronic hepatitis B and prolonged treatment may result in regression of fibrosis. The aim of this study was to investigate the effect of ETV on disease progression. DESIGN: In a multicentre cohort study, 372 ETV-treated patients were investigated. Clinical events were defined as development of hepatocellular carcinoma (HCC), hepatic decompensation or death. Virological response (VR) was defined as HBV DNA <80 IU/ml. RESULTS:Patients were classified as having chronic hepatitis B without cirrhosis (n=274), compensated cirrhosis (n=89) and decompensated cirrhosis (n=9). The probability of VR was not influenced by severity of liver disease (p=0.62). During a median follow-up of 20 months (IQR 11-32), the probability of developing clinical events was higher for patients with cirrhosis (HR 15.41 (95% CI 3.42 to 69.54), p<0.001). VR was associated with a lower probability of disease progression (HR 0.29 (95% CI 0.08 to 1.00), p=0.05) which remained after correction for established risk factors such as age. The benefit of VR was only significant in patients with cirrhosis (HR 0.22 (95% CI 0.05 to 0.99), p=0.04) and remained after excluding decompensated patients (HR 0.15 (95% CI 0.03 to 0.81), p=0.03). A higher HBV DNA threshold of 2000 IU/ml was not associated with the probability of disease progression (HR 0.20 (95% CI 0.03 to 1.10), p=0.10). CONCLUSION: VR to ETV is associated with a lower probability of disease progression in patients with cirrhosis, even after correction for possible baseline confounders. When using a threshold of 2000 IU/ml, the association between viral replication and disease progression was reduced, suggesting that complete viral suppression is essential for nucleoside/nucleotide analogue treatment, especially in patients with cirrhosis.
Authors: Vincent Wai-Sun Wong; Pietro Lampertico; Victor de Lédinghen; Pik Eu Chang; Seung Up Kim; Yongpeng Chen; Henry Lik-Yuen Chan; Giampaolo Mangia; Juliette Foucher; Wan Cheng Chow; Sang Hoon Ahn; Jinlin Hou Journal: Dig Dis Sci Date: 2015-01-07 Impact factor: 3.199
Authors: J Ahn; H M Lee; J K Lim; C Q Pan; M H Nguyen; W Ray Kim; A Mannalithara; H Trinh; D Chu; T Tran; A Min; S Do; H Te; K R Reddy; A S Lok Journal: Aliment Pharmacol Ther Date: 2015-10-28 Impact factor: 8.171
Authors: Joseph Ahn; Joseph K Lim; Hannah M Lee; Anna S Lok; Mindie Nguyen; Calvin Q Pan; Ajitha Mannalithara; Helen Te; K Rajender Reddy; Huy Trinh; Danny Chu; Tram Tran; Daryl Lau; Truong-Sinh Leduc; Albert Min; Loc Trong Le; Ho Bae; Sang Van Tran; Son Do; Hie-Won L Hann; Clifford Wong; Steven Han; Anjana Pillai; James S Park; Myron Tong; Steve Scaglione; Jocelyn Woog; W Ray Kim Journal: Am J Gastroenterol Date: 2016-06-21 Impact factor: 10.864
Authors: Scott Bowden; Stephen Locarnini; Ting-Tsung Chang; You-Chen Chao; Kwang-Hyub Han; Robert G Gish; Robert A de Man; Miao Yu; Cyril Llamoso; Hong Tang Journal: World J Gastroenterol Date: 2015-04-21 Impact factor: 5.742