Effect of antiviral therapy on long-term prognosis of patients with decompensated hepatitis B cirrhosis / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the effect of antiviral therapy on the long-term prognosis of patients with decompensated hepatitis B cirrhosis. MethodsA total of 132 patients with decompensated hepatitis B cirrhosis who were hospitalized in The People′s Hospital of Lezhi County 3 times or more from May 2009 to May 2012 were enrolled in the study. According to the therapies, the patients were divided into control group (51 patients) and observation group (81 patients). All the patients were followed up for 5 years via outpatient service and by telephone. Child-Pugh score and Model for End-Stage Liver Disease (MELD) score were obtained from all patients, and the reduction in HBV DNA, HBV DNA clearance, and liver function parameters were observed. Clinical outcomes were compared at the end of follow-up between the two groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThe observation group had significantly lower incidence rate of liver cancer, rate of liver transplantation, and mortality rate than the control group (χ2=4.32, 4.33, and 4.71, all P＜0.001). After treatment, the observation group showed a significant reduction in HBV DNA level (t=20.60, P＜0.001) and had a significantly lower HBV DNA level than the control group (t=16.40, P＜0.05). After treatment, the observation group had a significantly higher cumulative clearance rate of HBV DNA than the control group (88.89% vs 6.67%, P＜0.05). After treatment, the observation group had a significantly higher serum albumin level and significantly lower levels of total bilirubin (TBil) and alanine aminotransferase (ALT) than the control group (t=6.77, 16.60, and 11.67, all P＜0.001), and both groups showed significant reductions in TBil and ALT after treatment (observation group t=25.18 and 23.33, both P＜0.001; control group t=6.15 and 7.20, both P＜0.001). The observation group showed a significant increase in serum albumin level after treatment (t=10.08, P＜0.001). After treatment, the observation group had significantly lower Child-Pugh score and MELD score than the control group (t=2.27 and 2.24, both P＜0.05), both groups showed significant reductions in Child-Pugh score and MELD score (observation group t=9.18 and 8.17, P＜0.001 and P=0.03; control group t=2.93 and 3.12, P=0.01 and 0.04). ConclusionLong-term antiviral therapy can improve the long-term prognosis of patients with decompensated hepatitis B cirrhosis and increase the 5-year survival rate.