Monitoring the effect of antiviral treatment on the development of cirrhosis and hepatocellular carcinoma in chronic hepatitis B patients.

Revista da Associacao Medica Brasileira (1992) Pub Date : 2024-12-02 eCollection Date: 2024-01-01 DOI:10.1590/1806-9282.20240803
Kamil Mert, Bengu Tatar, Yasemin Nadir, Suheyla Serin Senger
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Abstract

Objective: Despite the availability of treatment and vaccines for chronic hepatitis B infection, it remains a public health problem. The use of nucleos(t)ide antiviral agents is effective in preventing complications such as cirrhosis and hepatocellular carcinoma, but despite the reduction, the risk persists. The objective of this study was to assess alterations in aspartate aminotransferase to platelet ratio index and Fibrosis-4 scores and examine the effectiveness of risk estimates for HCC in chronic hepatitis B scores in predicting the risk of hepatocellular carcinoma among chronic hepatitis B patients undergoing prolonged antiviral treatment.

Methods: This is a retrospective 10-year follow-up study that included chronic hepatitis B patients who received antiviral treatment. The alterations in aspartate aminotransferase to platelet ratio index and Fibrosis-4 scores were examined for the first, fifth, and tenth years. In addition, the expected long-term risk of hepatocellular carcinoma, if antiviral treatment was not initiated, was calculated using the risk estimates for HCC in chronic hepatitis B scores before treatment, and the incidence of hepatocellular carcinoma despite long-term antiviral treatment was compared with these values.

Results: The study included a total of 218 chronic hepatitis B patients. A noteworthy decline in aspartate aminotransferase to platelet ratio index and Fibrosis-4 scores was noted across all fibrosis groups, irrespective of the initial degree of fibrosis, during the first year of antiviral treatment. Following the calculation using risk estimates for HCC in chronic hepatitis B scores, one case was observed compared to the expected 15.04 cases of hepatocellular carcinoma.

Conclusion: We showed that both aspartate aminotransferase to platelet ratio index and Fibrosis-4 scores significantly decreased until the fifth year of antiviral treatment, with a prominent decline occurring in the first year. This study demonstrates that the impact of antiviral treatment on fibrosis can be monitored using noninvasive fibrosis scores.

监测抗病毒治疗对慢性乙型肝炎患者肝硬化和肝细胞癌发展的影响。
目的:尽管慢性乙型肝炎感染的治疗和疫苗的可用性,它仍然是一个公共卫生问题。使用核苷类抗病毒药物在预防肝硬化和肝细胞癌等并发症方面是有效的,但尽管减少了,风险仍然存在。本研究的目的是评估天冬氨酸转氨酶与血小板比值指数和纤维化-4评分的变化,并检验慢性乙型肝炎评分中HCC风险评估在长期接受抗病毒治疗的慢性乙型肝炎患者中预测肝细胞癌风险的有效性。方法:这是一项为期10年的回顾性随访研究,包括接受抗病毒治疗的慢性乙型肝炎患者。在第1年、第5年和第10年检查天冬氨酸转氨酶与血小板比值指数和纤维化-4评分的变化。此外,如果未开始抗病毒治疗,则使用治疗前慢性乙型肝炎评分中HCC的风险估计值计算肝细胞癌的预期长期风险,并将长期抗病毒治疗后肝细胞癌的发生率与这些值进行比较。结果:本研究共纳入218例慢性乙型肝炎患者。在抗病毒治疗的第一年,无论初始纤维化程度如何,所有纤维化组的天冬氨酸转氨酶与血小板比率指数和纤维化-4评分均显著下降。在计算慢性乙型肝炎评分中HCC的风险估计值后,与预期的15.04例肝细胞癌相比,观察到1例。结论:我们发现,在抗病毒治疗的第5年,天冬氨酸转氨酶血小板比值指数和纤维化-4评分均显著下降,在第1年下降明显。这项研究表明,抗病毒治疗对纤维化的影响可以通过无创纤维化评分来监测。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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