Dynamics of liver stiffness-based risk prediction model during antiviral therapy in patients with chronic hepatitis B

被引：7

作者：

Chon, Hye Yeon ^{[1
]}

Seo, Yeon Seok ^{[2
]}

Lee, Jung Il ^{[3
]}

Kim, Byung Seok ^{[4
]}

Jang, Byoung Kuk ^{[5
]}

Kim, Sang Gyune ^{[6
]}

Suk, Ki Tae ^{[7
]}

Kim, In Hee ^{[8
]}

Lee, Jin-Woo ^{[9
]}

Chon, Young Eun ^{[10
]}

Kim, Moon Young ^{[11
]}

Jeong, Soung Won ^{[12
]}

Lee, Han Ah ^{[2
]}

Yim, Sun Young ^{[2
]}

Um, Soon Ho ^{[2
]}

Lee, Hyun Woong ^{[3
]}

Lee, Kwan Sik ^{[3
]}

Song, Jeong Eun ^{[4
]}

Lee, Chang Hyeong ^{[4
]}

Chung, Woo Jin ^{[5
]}

Hwang, Jae Seok ^{[5
]}

Yoo, Jeong-Ju ^{[6
]}

Kim, Young Seok ^{[6
]}

Kim, Dong Joon ^{[7
]}

Lee, Chang Hun ^{[8
]}

Yu, Jung Hwan ^{[9
]}

Ha, Yeon Jung ^{[10
]}

Kim, Mi Na ^{[10
]}

Lee, Joo Ho ^{[10
]}

Hwang, Seong Gyu ^{[10
]}

Kang, Seong Hee ^{[11
]}

Baik, Soon Koo ^{[11
]}

Jang, Jae Young ^{[12
]}

Suh, Sang Jun ^{[13
]}

Jung, Young Kul ^{[13
]}

Kim, Beom Kyung ^{[1
]}

Park, Jun Yong ^{[1
]}

Kim, Do Young ^{[1
]}

Ahn, Sang Hoon ^{[1
]}

Han, Kwang-Hyub ^{[1
]}

Yim, Hyung Joon ^{[13
]}

Kim, Seung Up ^{[1
]}

机构：

[1] Yonsei Univ, Dept Internal Med, Coll Med, Yonsei Ro 50-1, Seoul, South Korea

[2] Korea Univ, Coll Med, Dept Internal Med, Seoul, South Korea

[3] Yonsei Univ, Gangnam Severance Hosp, Dept Internal Med, Coll Med, Seoul, South Korea

[4] Catholic Univ Daegu, Dept Internal Med, Sch Med, Daegu, South Korea

[5] Keimyung Univ, Dept Internal Med, Sch Med, Daegu, South Korea

[6] Soonchunhyang Univ, Dept Internal Med, Coll Med, Bucheon Hosp, Bucheon, South Korea

[7] Hallym Univ, Coll Med, Dept Internal Med, Chunchon, South Korea

[8] Chonbuk Natl Univ, Dept Internal Med, Med Sch, Jeonju, Jeonbuk, South Korea

[9] Inha Univ, Dept Internal Med, Sch Med, Incheon, South Korea

[10] CHA Univ, CHA Bundang Med Ctr, Dept Internal Med, Bundang, South Korea

[11] Yonsei Univ, Dept Internal Med, Wonju Coll Med, Wonju, South Korea

[12] Soonchunhyang Univ, Coll Med, Dept Internal Med, Seoul Hosp, Seoul, South Korea

[13] Korea Univ, Coll Med, Dept Internal Med, Ansan Hosp, Ansan, South Korea

来源：

EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY | 2021年 / 33卷 / 06期

基金：

新加坡国家研究基金会;

关键词：

antiviral therapy; chronic hepatitis B; hepatocellular carcinoma; risk prediction; transient elastography; HEPATOCELLULAR-CARCINOMA; TRANSIENT ELASTOGRAPHY; ENTECAVIR TREATMENT; FIBROSIS; VALIDATION;

D O I：

10.1097/MEG.0000000000001794

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Objective The liver stiffness-based risk prediction models predict hepatocellular carcinoma (HCC) development. We investigated the influence of antiviral therapy (AVT) on liver stiffness-based risk prediction model in patients with chronic hepatitis B (CHB). Methods Patients with CHB who initiated AVT were retrospectively recruited from 13 referral Korean institutes. The modified risk estimation for hepatocellular carcinoma in chronic hepatitis B (mREACH-B) model was selected for the analysis. Results Between 2007 and 2015, 1034 patients with CHB were recruited. The mean age of the study population (639 men and 395 women) was 46.8 years. During AVT, the mREACH-B score significantly decreased from the baseline to 3 years of AVT (mean 9.21 -> 7.46, P < 0.05) and was maintained until 5 years of AVT (mean 7.23, P > 0.05). The proportion of high-risk patients (mREACH-B score >= 11) was significantly reduced from the baseline to 2 years of AVT (36.4% -> 16.4%, P < 0.001) and was maintained until 5 years of AVT (12.2%, P > 0.05). The mREACH-B scores at baseline and 1 year of AVT independently predicted HCC development (hazard ratio = 1.209-1.224) (all P < 0.05). The cumulative incidence rate of HCC was significantly different at 5 years of AVT among risk groups (high vs. high-intermediate vs. low-intermediate vs. low) from baseline (4.5% vs. 3.2% vs. 1.5% vs. 0.8%) and 1 year (11.8% vs. 4.6% vs. 1.8% vs. 0.6%) (all P < 0.05, log-rank tests). Conclusions The mREACH-B score was dynamically changed during AVT. Thus, repeated assessment of the mREACH-B score is required to predict the changing risk of HCC development in patients with CHB undergoing AVT.

引用

页码：885 / 893

页数：9

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