单位:[1]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong‑an Road, Xi‑Cheng District, Beijing 100050, China 临床科室国家中心肝病分中心首都医科大学附属北京友谊医院[2] Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Beijing, China [3]National Clinical Research Center of Digestive Disease, Beijing, China [4]Department of Gastroenterology, Beijing Youan Hospital, Capital Medical University, Beijing, China [5]Division of Liver Fibrosis, The Fifth Medical Center, General Hospital of the People’s Liberation Army, Beijing, China [6]Liver Research Center, Beijing Ditan Hospital, Capital Medical University, Beijing, China [7]Office of Clinical Trials, Affiliated Hospital of Yanbian University, Yanji, Jilin, China [8]Division of Infectious Diseases, Peking University First Hospital, Beijing, China [9]Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, China [10]Liver Research Center, Peking University People’s Hospital, Beijing, China [11]Division of Infectious Diseases, China-Japan Friendship Hospital, Beijing, China
Background and aims Many models have been developed to predict liver-related events (LRE) in chronic hepatitis B, few focused on compensated HBV-induced cirrhosis. We aimed to describe the incidence of LRE and to determine independent risk predictors of LRE in compensated HBV-induced cirrhosis patients receiving antiviral therapy using routinely available parameters. Methods Prospective cohorts of treatment-naive adults with compensated HBV-induced cirrhosis were enrolled. Patients were treated with entecavir (ETV) or ETV + thymosin-alpha1 (Thy-alpha 1) or lamivudine (LAM) + adefovir (ADV). Data were collected at baseline and every 6 months. LRE was defined as development of decompensation, HCC or death. Results Totally 937 patients were included, 608 patients treated with ETV, 252 with ETV + Thy-alpha 1, and 77 with LAM + ADV. After a median follow-up of 4.5 years, 88 patients developed LRE including 48 with HCC. The cumulative incidence of LRE at year 1, 3, and 5 was 2.1%, 7.0%, and 12.7%, respectively, and was similar for three treatment groups. All models using variables at month 6 or 12 had better fit than models using baseline values. The best model for prediction of LRE used PLT, GGT, and AFP at month 6 [AUC: 0.762 (0.678-0.814)], for hepatic decompensation-PLT, LSM and GGT at month 12 (AUC: 0.834 (0.675-0.919)), and for HCC-AFP and GGT at month 6 [AUC 0.763 (0.691-0.828)]. All models had negative predictive values of 94.0-98.8%. Conclusion Models using on-treatment variables are more accurate than models using baseline variables in predicting LRE in patient with compensated HBV-induced cirrhosis receiving antiviral therapy. ClincialTrials.gov number NCT01943617, NCT01720238, NCT03366571, NCT02849132.
基金:
National Major Science and Technology Project [2018ZX10302204-004, 2018ZX09201016, 2017ZX10203202-003]; Project of Beijing Municipal Commission of Science and Technology [D161100002716003]; Project of the Digestive Medical Coordinated Development Center of Beijing Hospitals Authority [XXZ0405]
第一作者单位:[1]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong‑an Road, Xi‑Cheng District, Beijing 100050, China [2] Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Beijing, China [3]National Clinical Research Center of Digestive Disease, Beijing, China
通讯作者:
通讯机构:[1]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong‑an Road, Xi‑Cheng District, Beijing 100050, China [2] Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Beijing, China [3]National Clinical Research Center of Digestive Disease, Beijing, China
推荐引用方式(GB/T 7714):
Xiaoning Wu,Jialing Zhou,Yameng Sun,et al.Prediction of liver-related events in patients with compensated HBV-induced cirrhosis receiving antiviral therapy[J].HEPATOLOGY INTERNATIONAL.2021,15(1):82-92.doi:10.1007/s12072-020-10114-1.
APA:
Xiaoning Wu,Jialing Zhou,Yameng Sun,Huiguo Ding,Guofeng Chen...&Jidong Jia.(2021).Prediction of liver-related events in patients with compensated HBV-induced cirrhosis receiving antiviral therapy.HEPATOLOGY INTERNATIONAL,15,(1)
MLA:
Xiaoning Wu,et al."Prediction of liver-related events in patients with compensated HBV-induced cirrhosis receiving antiviral therapy".HEPATOLOGY INTERNATIONAL 15..1(2021):82-92