High risk of hepatocellular carcinoma and death in patients with immune-tolerant-phase chronic hepatitis B
DC Field | Value | Language |
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dc.contributor.author | Kim, Gi-Ae | - |
dc.contributor.author | Lim, Young-Suk | - |
dc.contributor.author | Han, Seungbong | - |
dc.contributor.author | Choi, Jonggi | - |
dc.contributor.author | Shim, Ju Hyun | - |
dc.contributor.author | Kim, Kang Mo | - |
dc.contributor.author | Lee, Han Chu | - |
dc.contributor.author | Lee, Yung Sang | - |
dc.date.available | 2020-02-27T10:42:33Z | - |
dc.date.created | 2020-02-07 | - |
dc.date.issued | 2018-05 | - |
dc.identifier.issn | 0017-5749 | - |
dc.identifier.uri | https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/3782 | - |
dc.description.abstract | Objective High serum HBV DNA levels are associated with high risks of hepatocellular carcinoma (HCC) and cirrhosis in patients with chronic hepatitis B (CHB). Although the immune-tolerant (IT) phase is characterised by high circulating HBV DNA levels, it remains unknown whether antiviral treatment reduces risks of HCC and mortality. Design This historical cohort study included HBeAg-(p)ositive patients with CHB with high HBV DNA levels (>= 20 000 IU/mL) and no evidence of cirrhosis at a tertiary referral hospital in Korea from 2000 to 2013. The clinical outcomes of 413 untreated IT-phase patients with normal alanine aminotransferase (ALT) levels (females, < 19 IU/mL; males, < 30 IU/mL) were compared with those of 1497 immune-active (IA)-phase patients (ALT = 80 IU/mL) treated with nucleos(t)ide analogues. Results The IT group was significantly younger than the IA group (mean age, 38 vs 40 years at baseline, p=0.04). The 10-year estimated cumulative incidences of HCC (12.7% vs 6.1%; p=0.001) and death/transplantation (9.7% vs 3.4%; p<0.001) were significantly higher in the IT group than the IA group. In multivariable analyses, the IT group showed a significantly higher risk of HCC (HR 2.54; 95% CI 1.54 to 4.18) and death/transplantation (HR 3.38; 95% CI 1.85 to 6.16) than the IA group, which was consistently identified through inverse probability treatment weighting, propensity score-matched and competing risks analyses. Conclusions Untreated IT-phase patients with CHB had higher risks of HCC and death/transplantation than treated IA-phase patients. Unnecessary deaths could be prevented through earlier antiviral intervention in select IT-phase patients. | - |
dc.language | 영어 | - |
dc.language.iso | en | - |
dc.publisher | BMJ PUBLISHING GROUP | - |
dc.relation.isPartOf | GUT | - |
dc.subject | CLINICAL-PRACTICE GUIDELINES | - |
dc.subject | TENOFOVIR DISOPROXIL FUMARATE | - |
dc.subject | PERSISTENTLY NORMAL ALT | - |
dc.subject | ANALOG THERAPY | - |
dc.subject | VIRUS DNA | - |
dc.subject | HBV DNA | - |
dc.subject | ALANINE AMINOTRANSFERASE | - |
dc.subject | ANTIVIRAL THERAPY | - |
dc.subject | POSITIVE PATIENTS | - |
dc.subject | CONTROLLED-TRIALS | - |
dc.title | High risk of hepatocellular carcinoma and death in patients with immune-tolerant-phase chronic hepatitis B | - |
dc.type | Article | - |
dc.type.rims | ART | - |
dc.description.journalClass | 1 | - |
dc.identifier.wosid | 000429733600018 | - |
dc.identifier.doi | 10.1136/gutjnl-2017-314904 | - |
dc.identifier.bibliographicCitation | GUT, v.67, no.5, pp.945 - 952 | - |
dc.identifier.scopusid | 2-s2.0-85045092869 | - |
dc.citation.endPage | 952 | - |
dc.citation.startPage | 945 | - |
dc.citation.title | GUT | - |
dc.citation.volume | 67 | - |
dc.citation.number | 5 | - |
dc.contributor.affiliatedAuthor | Han, Seungbong | - |
dc.type.docType | Article | - |
dc.subject.keywordAuthor | antiviral therapy | - |
dc.subject.keywordAuthor | chronic viral hepatitis | - |
dc.subject.keywordAuthor | hepatitis B | - |
dc.subject.keywordAuthor | hepatocellular carcinoma | - |
dc.subject.keywordAuthor | liver transplantation | - |
dc.subject.keywordPlus | CLINICAL-PRACTICE GUIDELINES | - |
dc.subject.keywordPlus | TENOFOVIR DISOPROXIL FUMARATE | - |
dc.subject.keywordPlus | PERSISTENTLY NORMAL ALT | - |
dc.subject.keywordPlus | ANALOG THERAPY | - |
dc.subject.keywordPlus | VIRUS DNA | - |
dc.subject.keywordPlus | HBV DNA | - |
dc.subject.keywordPlus | ALANINE AMINOTRANSFERASE | - |
dc.subject.keywordPlus | ANTIVIRAL THERAPY | - |
dc.subject.keywordPlus | POSITIVE PATIENTS | - |
dc.subject.keywordPlus | CONTROLLED-TRIALS | - |
dc.relation.journalResearchArea | Gastroenterology & Hepatology | - |
dc.relation.journalWebOfScienceCategory | Gastroenterology & Hepatology | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
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