Hepatocellular Carcinoma Risk of Compensated Cirrhosis Patients with Elevated HBV DNA Levels according to Serum Aminotransferase Levels
Journal of Korean Medical Science
;
: 1618-1624, 2015.
Article
Dans Anglais
| WPRIM
| ID: wpr-66173
ABSTRACT
Sometimes, hepatitis B virus (HBV)-related cirrhotic patients with normal aminotransferase levels are closely followed-up for the elevation of aminotransferase levels instead of prompt antiviral therapy (AVT). We analyzed the long-term hepatocellular carcinoma (HCC) risk according to the aminotransferase levels in a retrospective cohort of 1,468 treatment-naive, HBV-related, compensated cirrhosis patients with elevated HBV DNA levels (> or =2,000 IU/mL). Based on aminotransferase levels, patients were categorized into normal ( or =40 U/L, n = 1,104). During a median of 5.3 yr of follow-up (range 1.0-8.2 yr), HCC developed in 296 (20%) patients. The 5-yr cumulative HCC incidence rate was higher in patients with elevated aminotransferase level, but was not low in normal aminotransferase level (17% vs. 14%, P = 0.004). During the follow-up, 270/364 (74%) patients with normal aminotransferase levels experienced elevation of aminotransferase levels, and AVT was initiated in 1,258 (86%) patients. Less patients with normal aminotransferase levels received AVT (70% vs. 91%, P < 0.001) and median time to start AVT was longer (17.9 vs. 2.4 months, P < 0.001). AVT duration was an independent factor associated with HCC, and median duration of AVT was shorter (4.0 vs. 2.6 yr, P < 0.001) in patients with normal aminotransferase levels. The HCC risk of compensated cirrhosis patients with normal aminotransferase level is not low, and AVT duration is associated with lowered HCC risk, indicating that prompt AVT should be strongly considered even for those with normal aminotransferase levels.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
ADN viral
/
Marqueurs biologiques
/
Comorbidité
/
Virus de l'hépatite B
/
Incidence
/
Causalité
/
Reproductibilité des résultats
/
Facteurs de risque
/
Sensibilité et spécificité
/
Carcinome hépatocellulaire
Type d'étude:
Etude diagnostique
/
Etude d'étiologie
/
Etude d'incidence
/
Étude pronostique
/
Facteurs de risque
Limites du sujet:
Femelle
/
Humains
/
Mâle
Pays comme sujet:
Asie
langue:
Anglais
Texte intégral:
Journal of Korean Medical Science
Année:
2015
Type:
Article
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