J Gastroenterol Hepatol. 2023 Jan 21. doi: 10.1111/jgh.16132. Online ahead of print.
ABSTRACT
BACKGROUNDS: Antiviral therapy (AVT) is the mainstay of hepatitis B virus (HBV) management. We investigated whether AVT improves the outcomes of HBV-related decompensated cirrhosis and undetectable HBV DNA.
METHODS: Between 2000 and 2017, treatment-naïve patients with HBV-related decompensated cirrhosis and undetectable HBV DNA were recruited from two tertiary hospitals. The endpoints included death and hepatocellular carcinoma (HCC).
RESULTS: A total of 429 patients were analyzed (50 and 379 patients in the AVT and Non-AVT groups, respectively). Patients in the AVT group were significantly younger and had higher alanine aminotransferase and alpha-fetoprotein levels than those in the non-AVT group (all P<0.05). During follow-up (median 49.6 months), 98 patients died and 105 developed HCC. The cumulative incidence rates of death (2.0%, 4.1%, and 6.4%, and 4.9%, 7.2%, and 10.2% at 6 months, 1 and 2 years, respectively) and HCC (8.6%, 15.8%, and 26.4% vs. 1.6%, 7.7%, and 24.4% at 1, 2, and 5 years, respectively) were statistically comparable between AVT and non-AVT groups (all P>0.05). Using Cox regression analysis, AVT was not significantly associated with death nor HCC (all P>0.05). Similar results were observed after balancing baseline characteristics with IPTW. In non-AVT group, the cumulative incidence rate of HBV DNA detection at 6 months, 1 and 2 years were 2.0%, 3.1%, and 6.4%, respectively.
CONCLUSIONS: AVT did not attenuate the risk of death nor HCC in patients with HBV-related decompensated cirrhosis and undetectable HBV DNA.
PMID:36681856 | DOI:10.1111/jgh.16132
