Influence of different virologic responses on the prognosis of patients with decompensated hepatitis B cirrhosis / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the influence of different virologic responses on long-term survival rate and incidence rate of liver cancer in patients with decompensated hepatitis B cirrhosis. MethodsA total of 378 patients with decompensated hepatitis B cirrhosis who were admitted to The Affiliated Hospital of Xuzhou Medical University from September 2010 to September 2016 were enrolled, and according to whether HBV DNA was continuously undetectable during antiviral therapy, they were divided into sustained virologic response group with 243 patients and non-sustained virologic response group with 135 patients. The patients were stratified according to the application of different antiviral drugs. Baseline data were recorded and the patients were followed up to the occurrence of end events or study endpoint to record death and hepatocellular carcinoma (HCC). The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to plot survival curves, and the log-rank test was used to compare survival rates between groups. ResultsCompared with the non-sustained virologic response group, the sustained virologic response group had a significantly lower 5-year cumulative incidence rate of HCC (7.4% vs 19.3%, χ2=10.627, P=0.001) and a significantly higher 5-year transplant-free survival rate (93.4% vs 80.7%, χ2=12.594, P＜0.001). For the sustained virologic response group, there were no significant differences between the entecavir group and the non-entecavir group in the 5-year transplant-free survival rate (94.7% vs 90.2%, χ2=1.122, P=0.290) and the 5-year cumulative incidence rate of liver cancer (6.4 % vs 9.7%, χ2=0.552, P=0.458). For the non-sustained viral response group, there were also no significant differences between the entecavir group and the non-entecavir group in the 5-year transplant-free survival rate (78.4% vs 82.8%, χ2=1.526, P=0.217) and the 5-year cumulative incidence rate of liver cancer (21.5% vs 17.1%, χ2=1.844, P=0.174). ConclusionAntiviral therapy can improve the prognosis of patients with decompensated hepatitis B cirrhosis, and sustained virologic response can reduce the incidence rate of liver cancer and prolong survival time.