Antiviral Therapy Favors a Lower Risk of Liver Cirrhosis in HBeAg-negative Chronic Hepatitis B with Normal Alanine Transaminase and HBV DNA Positivity.
J Clin Transl Hepatol
; 11(7): 1465-1475, 2023 Dec 28.
Article
en En
| MEDLINE
| ID: mdl-38161505
ABSTRACT
Background and Aims:
Direct evidence on the outcomes of hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients with normal alanine transaminase after long-term antiviral treatment is lacking.Methods:
HBeAg-negative patients with normal ALT and positive HBV DNA (≥20 IU/mL) were retrospectively enrolled. The endpoints included virological response (HBV DNA<100 IU/mL), changes in aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 index (FIB-4), and the incidence of liver nodules, cirrhosis, and hepatocellular carcinoma (HCC).Results:
This cohort (n=194) was divided into three subgroups, untreated (n=67), treatment-continued (n=87), and treatment-discontinued patients (n=40), with a median follow-up of 54 months. The treatment-continued group achieved 100% (95% CI 94.7-100) virological response, and significantly reduced APRI and FIB-4 scores (both p<0.001). The risk of liver nodules and cirrhosis in that group was reduced by 76% (HR 0.24, 95% CI 0.11-0.54, p<0.001) and 89% (HR 0.11, 95% CI 0.14-0.91, p=0.041) vs. the untreated group and by 77% (HR 0.23, 95% CI 0.10-0.49, p<0.001) and 95% (HR 0.05, 95% CI 0.01-0.44, p=0.006) vs. the treatment-discontinued group. For patients with HBV DNA≥2,000 IU/mL, adherence to treatment lowered the risks of liver cirrhosis by 92% (95% CI 0.01-0.67) and 93% (95% CI 0.01-0.53) vs. the untreated and treatment-discontinued patients, respectively. No patient adhering to treatment developed HCC, but one in each of the remaining groups did.Conclusions:
Continuous nucleos(t)ide analog (NA) treatment has a satisfactory effectiveness and helps to lower the risk of liver cirrhosis in HBeAg-negative CHB patients with normal alanine transaminase, especially in those with HBV DNA≥2,000 IU/mL.
Texto completo:
1
Colección:
01-internacional
Tipo de estudio:
Etiology_studies
/
Risk_factors_studies
Idioma:
En
Revista:
J Clin Transl Hepatol
Año:
2023
Tipo del documento:
Article
País de afiliación:
China