한빛사논문
- 조회455
Huang, Daniel Q. MBBS1,2; Tamaki, Nobuharu MD, PhD3; Lee, Hyung Woong MD, PhD4; Park, Soo Young MD, PhD5; Lee, Yu Rim MD, PhD5; Lee, Hye Won MD, PhD4; Lim, Seng Gee MBBS1,2; Lim, Tae Seop MD, PhD4; Kurosaki, Masayuki MD, PhD3; Marusawa, Hiroyuki MD, PhD6; Mashiba, Toshie MD, PhD7; Kondo, Masahiko MD, PhD8; Uchida, Yasushi MD, PhD9; Kobashi, Haruhiko MD, PhD10; Furuta, Koichiro MD, PhD11; Izumi, Namiki MD, PhD3; Kim, Beom Kyung MD, PhD4; Sinn, Dong Hyun MD, PhD12
1Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
2Division of Gastroenterology and Hepatology, National University Hospital, Singapore
3Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
4Department of Internal medicine, Yonsei University College of medicine, Seoul, Republic of Korea
5Department of Internal medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
6Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan;
7Center for Liver-Biliary-Pancreatic Disease, Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan
8Department of Gastroenterology, Japanese Red Cross Otsu Hospital, Otsu, Shiga, Japan
9Department of Gastroenterology, Matsue Red Cross Hospital, Matsue, Shimane, Japan
10Department of Gastroenterology, Japanese Red Cross Okayama Hospital, Okayama, Okayama, Japan
11Department of Gastroenterology, Masuda Red Cross Hospital, Masuda, Shimane, Japan
12Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Daniel Q. Huang and Nobuharu Tamaki: Two co-first authors equally contributed to this work.
Correspondence Beom Kyung Kim, MD, PhD, Dong Hyun Sinn, MD, PhD
Abstract
Background: Comparative outcomes of hepatitis B virus (HBV)-infected compensated cirrhosis with low-level viremia (LLV) versus maintained virological response (MVR) are unclear. We conducted a large, multi-ethnic, multi-center study to examine the natural history of LLV versus MVR in compensated cirrhosis.
Methods: We enrolled patients with HBV-infected compensated cirrhosis (n=2,316) from 19 hospitals in South Korea, Singapore, and Japan. We defined low-level viraemia (LLV) group as untreated patients with≥1 detectable serum HBV-DNA (20-2,000 IU/mL), Spontaneous-MVR group as untreated patients with spontaneously achieved MVR, and antiviral therapy (AVT)-MVR group as patients achieving AVT-induced MVR. Study endpoints were hepatocellular carcinoma (HCC) or hepatic decompensation.
Results: The annual HCC incidence was 2.7/100 person-years (PYs), 2.6/100 PYs, and 3.3/100 PYs for LLV (n=742), Spontaneous-MVR (n=333), and AVT-MVR (n=1,241) groups, respectively ( P =0.81 between LLV vs. Spontaneous-MVR groups and P =0.37 between LLV vs. AVT-MVR groups). Similarly, the annual decompensation incidence was 1.6/100 PYs, 1.9/100 PYs, and 1.6/100 PYs for LLV, Spontaneous-MVR, and AVT-MVR groups, respectively ( P =0.40 between LLV vs. Spontaneous-MVR groups and P =0.83 between LLV vs. AVT-MVR groups). Multivariable analyses determined that HCC and decompensation risks in LLV group were comparable to those with Spontaneous-MVR and AVT-MVR groups (all P >0.05). Propensity score-matching also reproduced similar results for HCC and decompensation risks (all P >0.05 between LLV vs. Spontaneous-MVR groups and between LLV vs. AVT-MVR groups).
Conclusions: Untreated LLV in HBV-infected compensated cirrhosis is not associated with increased risk of disease progression compared to Spontaneous-MVR and AVT-MVR. These data have important implications for practice and further research.
논문정보
- Research article
- 2023년 01월 (BRIC 등록일 2023-03-24)
- 국내(교신)+국외 연구진
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