On‐treatment changes of liver stiffness at week 26 could predict 2‐year clinical outcomes in <scp>HBV</scp>‐related compensated cirrhosis

Wu, Shanshan; Kong, Yuanyuan; Piao, Hulin; Jiang, Wei; Xie, Wen; Chen, Yongpeng; Lu, Lungen; Ma, Anlin; Xie, Shi-Bin; Ding, Huiguo; Shang, Jia; Zhang, Xuqing; Feng, Bo; Han, Tao; Xu, Xiaoyuan; Huo, Lijuan; Cheng, Jun; Li, Hai; Wu, Xiaoning; Zhou, Jialing; Sun, Yameng; Ou, Xiaojuan; Zhang, Hui; You, Hong; Jia, Jidong

doi:10.1111/liv.13623

Cited by 33 publications

(30 citation statements)

References 33 publications

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“…The diagnosis of decompensated cirrhosis is based on cirrhosis with portal and venous hypertension complications and/or liver dysfunction. (1) Having the diagnosis basis of cirrhosis; (2) having the complications related to portal hypertension, such as ascites, esophageal, and gastric varices bleeding, hepatic encephalopathy [ 18 ]. HCC was diagnosed by standard histological and/or compatible radiological findings.…”

Section: Methodsmentioning

confidence: 99%

Adjuvant Fuzheng Huayu Capsule Reduces the Incidence of Hepatocellular Carcinoma in Patients with Hepatitis B‐Caused Cirrhosis

Shi

Liu

Wang

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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Aim. Fuzhenghuayu (FZHY) capsule can inhibit the progression of cirrhosis. This study explored whether FZHY can reduce the incidence of hepatocellular carcinoma (HCC) in patients with hepatitis B-caused cirrhosis (HBC) undergoing antiviral therapy. Methods. A retrospective review of 842 patients with HBC between 2011 and 2015 was performed, including 270 treated with FZHY combined with nucleos (t) ide analogues (NAs) and 572 with NAs alone. The incidence of HCC was compared between the FZHY (n = 259) and control (n = 259) groups using 1 : 1 propensity score (PS) matching. The incidence of HCC in patients with HBC with different Child-Turcotte-Pugh (CTP) classifications and Toronto HCC risk index (THRI) scores was analyzed using Kaplan–Meier curves. Results. The 5-year cumulative incidence of HCC before and after PS matching was 151 (17.9%) and 86 (16.6%), respectively. In PS-matched samples, the multivariate Cox proportional-hazards model indicated that the FZHY group demonstrated a significantly lower risk for HCC than the control group (adjusted hazard ratio [aHR] = 0.32, 95% CI 0.19–0.53 P < 0.001 ). The risk of HCC diminished with increased duration of FZHY use. The stratified analysis revealed that the FZHY group, regardless of CTP classification, benefited significantly from FZHY therapy. Patients in the medium- and high-THRI risk groups were the dominant population for FZHY. Conclusions. FZHY combined with NAs was associated with a significantly lower risk of HCC than NAs alone in patients with HBC, which supports the integration of FZHY with antiviral treatment into clinical practice.

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Section: Methodsmentioning

confidence: 99%

Adjuvant Fuzheng Huayu Capsule Reduces the Incidence of Hepatocellular Carcinoma in Patients with Hepatitis B‐Caused Cirrhosis

Shi

Liu

Wang

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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“…125,126 Importantly, the currently available evidence is restricted to the earlier-mentioned studies in patients with HCV-induced ACLD as well as cohorts comprising patients with HBV-induced ACLD. 127 Thus, it has yet to be evaluated whether noninvasive methods are capable of monitoring the evolution of portal hypertension and predicting clinical outcomes in patients with ACLD who underwent other etiological therapies.…”

Section: Monitoring the Evolution Of Portal Hypertension And Predictimentioning

confidence: 99%

Noninvasive Diagnostics for Portal Hypertension: A Comprehensive Review

et al. 2020

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Noninvasive diagnostics for portal hypertension include imaging and functional tests, as well as blood-based biomarkers, and capture different features of the portal hypertensive syndrome. Definitive conclusions regarding their clinical utility require assessment of their diagnostic value in specific clinical settings (i.e., diagnosing a particular hemodynamic condition within a well-defined target population). Several noninvasive methods are predictive of clinically significant portal hypertension (CSPH; hepatic venous pressure gradient [HVPG] ≥ 10 mm Hg; the threshold for complications of portal hypertension); however, only a minority of them have been evaluated in compensated advanced chronic liver disease (i.e., the target population). Importantly, most methods correlate only weakly with HVPG at high values (i.e., in patients with CSPH). Nevertheless, selected methods show promise for diagnosing HVPG ≥ 16 mm Hg (the cut-off for increased risks of hepatic decompensation and mortality) and monitoring HVPG changes in response to nonselective beta-blockers or etiological treatments. Finally, we review established and potential future clinical applications of noninvasive methods.

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“…Baseline LS measurement has been demonstrated useful in HCC prediction for patients with chronic hepatitis B or C infection with or without antiviral treatment . Serial LS value also impacts the clinical outcomes including HCC occurrence . Not only baseline LS value, but also the magnitude of its change after antiviral therapy was useful in the prediction of liver‐related events including HCC .…”

Section: Discussionmentioning

confidence: 99%

“…Serial LS value also impacts the clinical outcomes including HCC occurrence . Not only baseline LS value, but also the magnitude of its change after antiviral therapy was useful in the prediction of liver‐related events including HCC . For HBV‐related cirrhosis patients achieving 25‐30% reduction from baseline LS value measured before NA treatment, the clinical outcome was better than those not receiving such reduction .…”

Section: Discussionmentioning

confidence: 99%

“…However, the magnitude of reduction from the first LS value measured at CVR, either in absolute or relative values, was not associated with HCC development. Compared to patients with non‐cirrhosis and compensated cirrhosis enrolled in previous studies, this study cohort was comprised of cirrhosis patients with decompensation, whose degree of LS reduction after CVR might be too small to translate into HCC risk reduction. Instead of liver‐related events, our study end‐point was HCC occurrence where the pathogenic mechanisms involved not only HBV proliferation and liver injury, but also HBV integration in the host genome .…”

Section: Discussionmentioning

confidence: 99%

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Liver stiffness measurement at complete virological response in hepatoma prediction for HBV‐related cirrhosis patient with potent antiviral agent

Wang

Chen

et al. 2019

The Kaohsiung J of Med Scie

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Hepatocellular carcinoma (HCC) development is ameliorated with nucleos(t)ide agent (NA) therapy for hepatitis B virus (HBV)-related cirrhosis patients. This study investigates whether liver stiffness (LS) measurement at complete virological response (CVR) was useful in predicting HCC development. Between July 2006 and August 2016, HBVrelated cirrhosis patients with potent NA (entecavir/tenofovir) with the first LS measurement during CVR and with serial LS were enrolled. Patients developing HCC 6 months after potent NA or before the first LS measurement were excluded. Three hundred and seventy-one patients were enrolled. The median follow-up was 5.6 and 3.8 years from potent NA treatment and the first LS measurement respectively. Twenty-seven patients developed HCC. The 1-, 3-, 5-and 7-year cumulated incidences of HCC occurrencewere 0%, 2.8%, 5.8% and 9%, respectively. In addition to age > 57 years, LS > =21.5 kPa (HR: 3.86, 95%CI: 1.67-8.94) was an independent factor associated with HCC occurrence in multivariate analysis. However, the magnitude of change in LS was not associated with HCC development. For the first LS in HCC prediction, the performance was 0.636. There were two to thirteen LS measurements during CVR. The change in LS was classified into four patterns stratified by the first and serial LS. Compared with those with serial LS < 21.5 kPa, patients with LS > =21.5 kPa tend to have higher HCC occurrence (P = .062). In summary, LS at CVR was an independent factor associated with HCC development for HBV-related cirrhosis patients with potent NA. However, LS was not satisfactory in the prediction performance of HCC development. K E Y W O R D S hepatic cirrhosis, hepatitis B virus, hepatocellular carcinoma, liver stiffness, nucleos(t)ide agent

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On‐treatment changes of liver stiffness at week 26 could predict 2‐year clinical outcomes in HBV‐related compensated cirrhosis

Abstract: Dynamic changes of LSM alone, or combined with baseline albumin, could predict LREs in patients with HBV-related compensated cirrhosis during antiviral therapy.

Cited by 33 publications

References 33 publications

Adjuvant Fuzheng Huayu Capsule Reduces the Incidence of Hepatocellular Carcinoma in Patients with Hepatitis B‐Caused Cirrhosis

Adjuvant Fuzheng Huayu Capsule Reduces the Incidence of Hepatocellular Carcinoma in Patients with Hepatitis B‐Caused Cirrhosis

Noninvasive Diagnostics for Portal Hypertension: A Comprehensive Review

Liver stiffness measurement at complete virological response in hepatoma prediction for HBV‐related cirrhosis patient with potent antiviral agent

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