Influence of hepatic steatosis on the outcomes of patients with chronic hepatitis B treated with entecavir and tenofovir.
Clin Mol Hepatol
; 25(3): 283-293, 2019 09.
Article
em En
| MEDLINE
| ID: mdl-30419649
ABSTRACT
BACKGROUND/AIMS:
The influence of hepatic steatosis (HS) on chronic hepatitis B (CHB) is unclear. We evaluated the influence of the degree of HS, assessed using the controlled attenuation parameter (CAP) of transient elastography (TE), on treatment outcomes in CHB patients initiated on antiviral therapy.METHODS:
A total of 334 patients who were initiated on entecavir or tenofovir between 2007 and 2016 with available TE results were recruited.RESULTS:
Of the total study population, 146 (43.7%) patients had HS (CAP > 238 dB/m). Three-hundred-three patients (90.7%) achieved complete virological response (CVR) (hepatitis B virus DNA<12 IU/L), and 25 patients (7.5%) developed hepatocellular carcinoma (HCC). Among hepatitis B e antigen (HBeAg)-positive patients (n=172, 51.5%), 37 (21.5%) experienced HBeAg loss. On univariate analysis, CAP value was not associated with the probability of HCC development (P=0.380). However, lower CAP value was independently associated with higher probability of HBeAg loss among HBeAg-positive patients (hazard ratio [HR]=0.991, P=0.026) and with CVR achievement in the entire study population (HR=0.996, P=0.004). The cumulative incidence of HBeAg loss among HBeAg-positive patients was significantly higher in patients without HS than in those with HS (log-rank, P=0.022).CONCLUSION:
CAP values were not correlated with HCC development in patients initiated on entecavir and tenofovir. However, CAP values were negatively correlated with the probability of HBeAg loss among HBeAg-positive patients and with CVR achievement.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Antivirais
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Hepatite B Crônica
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Fígado Gorduroso
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Tenofovir
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Guanina
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article