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Effect of virological response to entecavir on the development of hepatocellular carcinoma in hepatitis B viral cirrhotic patients: comparison between compensated and decompensated cirrhosis.

DC Field Value Language
dc.contributor.authorKim, SS-
dc.contributor.authorHwang, JC-
dc.contributor.authorLim, SG-
dc.contributor.authorAhn, SJ-
dc.contributor.authorCheong, JY-
dc.contributor.authorCho, SW-
dc.date.accessioned2016-03-31T06:42:48Z-
dc.date.available2016-03-31T06:42:48Z-
dc.date.issued2014-
dc.identifier.issn0002-9270-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/12327-
dc.description.abstractOBJECTIVES: This study aimed to evaluate the risk of development of

hepatocellular carcinoma (HCC) according to underlying liver status and

virological response (VR) to entecavir (ETV) in chronic hepatitis B patients with

cirrhosis. Procollagen III N-terminal peptide (PIIINP) concentration during ETV

treatment and its association with HCC development were also evaluated. METHODS:

A total of 306 patients with clinically diagnosed liver cirrhosis were treated

with ETV for >/=12 months and were subsequently followed up for the occurrence of

HCC (median follow-up duration: 37.0 months). Patients who developed HCC within

12 months were excluded. VR was defined as a hepatitis B virus DNA level <20

IU/ml at 12 months after ETV treatment. RESULTS: A total of 209 patients (68.3%)

had compensated cirrhosis, and the remaining patients (31.7%) had decompensated

cirrhosis. The 5-year cumulative incidence of HCC was 26.8%. A multivariate Cox

regression analysis identified the following independent risk factors for

developing HCC in all the patients: age >50 years (hazard ratio (HR)=8.41; 95%

confidence interval (CI)=3.86-18.28; P=0.000), male sex (HR=4.24; 95%

CI=1.83-9.81; P=0.001), high serum PIIINP level at 12 months (HR=1.07; 95%

CI=1.02-1.13; P=0.007), and no VR at 12 months (HR=2.10; 95% CI=1.02-4.33;

P=0.043). The subgroup analyses showed that no VR at 12 months is a significant

risk factor for developing HCC in the patients with decompensated cirrhosis

(HR=7.74; 95% CI=1.34-44.78; P=0.022) but not in those with compensated cirrhosis

(P=0.749). CONCLUSIONS: The antiviral treatment with ETV did not completely

eliminate the risk of developing HCC in our patients with cirrhosis. However, VR

to ETV was associated with a low probability that the patients with decompensated

cirrhosis would develop HCC.
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dc.language.isoen-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHAged, 80 and over-
dc.subject.MESHAntiviral Agents-
dc.subject.MESHBiomarkers, Tumor-
dc.subject.MESHCarcinoma, Hepatocellular-
dc.subject.MESHFemale-
dc.subject.MESHGuanine-
dc.subject.MESHHepatitis B, Chronic-
dc.subject.MESHHumans-
dc.subject.MESHIncidence-
dc.subject.MESHLiver Cirrhosis-
dc.subject.MESHLiver Neoplasms-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHRepublic of Korea-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHRisk Factors-
dc.subject.MESHTreatment Outcome-
dc.titleEffect of virological response to entecavir on the development of hepatocellular carcinoma in hepatitis B viral cirrhotic patients: comparison between compensated and decompensated cirrhosis.-
dc.typeArticle-
dc.identifier.pmid24890440-
dc.identifier.urlhttp://www.nature.com/ajg/journal/v109/n8/full/ajg2014145a.html-
dc.contributor.affiliatedAuthor김, 순선-
dc.contributor.affiliatedAuthor황, 재철-
dc.contributor.affiliatedAuthor임, 선교-
dc.contributor.affiliatedAuthor안, 선주-
dc.contributor.affiliatedAuthor정, 재연-
dc.contributor.affiliatedAuthor조, 성원-
dc.type.localJournal Papers-
dc.identifier.doi10.1038/ajg.2014.145-
dc.citation.titleThe American journal of gastroenterology-
dc.citation.volume109-
dc.citation.number8-
dc.citation.date2014-
dc.citation.startPage1223-
dc.citation.endPage1233-
dc.identifier.bibliographicCitationThe American journal of gastroenterology, 109(8). : 1223-1233, 2014-
dc.identifier.eissn1572-0241-
dc.relation.journalidJ000029270-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
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