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The impact of newer nucleos(t)ide analogues on patients with hepatitis B decompensated cirrhosis

E. Cholongitas,G. Papatheodoridis,J. Goulis,J. Vlachogiannakos,S. Karatapanis,J. Ketikoglou,T. Vasiliadis,George Kontos,A. Karlaftis,E. Akriviadis

Published 2015 in Annals of gastroenterology : quarterly publication of the Hellenic Society of Gastroenterology

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.

PUBLICATION RECORD

  • Publication year

    2015

  • Venue

    Annals of gastroenterology : quarterly publication of the Hellenic Society of Gastroenterology

  • Publication date

    Unknown publication date

  • Fields of study

    Medicine

  • Identifiers
    PMID 25608681PMCID 4289983
  • External record

    Open on Semantic Scholar

  • Source metadata

    Semantic Scholar, PubMed

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