The impact of newer nucleos(t)ide analogues on patients with hepatitis B decompensated cirrhosis.
Τίτλος | The impact of newer nucleos(t)ide analogues on patients with hepatitis B decompensated cirrhosis. |
Publication Type | Journal Article |
Year of Publication | 2015 |
Authors | Cholongitas, E., Papatheodoridis G. V., Goulis J., Vlachogiannakos J., Karatapanis S., Ketikoglou J., Vasiliadis T., Kontos G., Karlaftis A., & Akriviadis E. |
Journal | Ann Gastroenterol |
Volume | 28 |
Issue | 1 |
Pagination | 109-117 |
Date Published | 2015 Jan-Mar |
ISSN | 1108-7471 |
Abstract | BACKGROUND/AIM: Patients with HBV-related decompensated cirrhosis (HBV-DeCi) should be treated with potent nucleos(t)ide analogues (NA)[entecavir (ETV) or tenofovir (TDF)]. The aim was the evaluation of safety and efficacy in terms of changes in liver disease course in HBV-DeCi patients treated with ETV or TDF.METHODS: In 52 HBV-DeCi patients clinical and laboratory data, including glomerular filtration rates (GFR), were recorded. The changes in MELD (DMELD) and Child-Pugh (DCTP) scores between baseline and after 6 months of treatment were evaluated. The independent factors associated with survival were evaluated.RESULTS: 31 patients under TDF and 21 under ETV were evaluated. During a median follow-up of 22.5 months (range: 6-68), there were no differences between the two groups in GFR and serum phosphate levels. At the end of follow up, in the TDF group, 2 patients died and 3 received liver transplantations (LT), while in the ETV group, 1 patient died and 3 received LT. In multivariable Cox regression analysis, DMELD was independently associated with the outcome in the total cohort (HR: 1.78, 95%C.I.:1.12-2.79, P=0.013) as well as in the subgroup of naïve (n=37) patients (HR: 1.8, 95%C.I.:1.19-4.5, P=0.03). Finally, in the non-hepatocellular carcinoma patients, the DCTP score was independently associated with the outcome in the total cohort (HR: 2.64, 95%C.I.: 1.21-7.29, P=0.015).CONCLUSIONS: TDF and ETV appear to have similar renal safety profile in HBV-DeCi patients. DMELD score in the total cohort and DCTP score in non-HCC patients were independently associated with the outcome; these findings need confirmation in larger studies. |
Alternate Journal | Ann Gastroenterol |
PubMed ID | 25608681 |
PubMed Central ID | PMC4289983 |