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  • Wiley  (3)
  • Lee, Hye Won  (3)
  • Tak, Won Young  (3)
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  • Wiley  (3)
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  • 1
    In: Journal of Viral Hepatitis, Wiley, Vol. 27, No. 12 ( 2020-12), p. 1352-1358
    Abstract: The risk of developing hepatitis B virus (HBV)‐related hepatocellular carcinoma (HCC) is reduced by antiviral therapy. Here, we evaluated the chronological trends in HCC development risk starting in 2007, when entecavir reimbursement was first initiated in South Korea. Treatment‐naïve patients with chronic hepatitis B (CHB) receiving entecavir 0.5 mg/d were stratified into three groups according to entecavir start time: early (2007‐2010), middle (2011‐2012) and late (2013‐2014) cohorts Among 2442 patients, cumulative probabilities of developing HCC after 1, 3 and 5 years were, respectively, 1.7%, 5.1%, and 8.2% (early cohort; n = 672); 1.5%, 5.1% and 8.9% (middle cohort; n = 757); and 1.2%, 5.3% and 10.6% (late cohort; n = 1013; P   〉  .05 between each pair). Older age, male, positive hepatitis B e antigen, liver cirrhosis, Child‐Pugh class B (vs A) and lower platelet count significantly predicted HCC development in univariate analysis ( P   〈  .001), whereas entecavir start time (early vs middle vs late cohorts) did not affect the risk of HCC development ( P  = .457). A multivariate analysis revealed that older age (adjusted hazard ratio [aHR]=1.041), male gender (aHR = 2.069), liver cirrhosis (aHR = 3.771) and Child‐Pugh class B (vs A, aHR = 1.548) were independently associated with an increased risk of HCC development, whereas higher platelet count was independently associated with a reduced risk of HCC development (aHR = 0.993; all P   〈  .05). In conclusion, the risk of developing HCC among patients receiving entecavir in South Korea has been stable since 2007. To establish more effective HCC surveillance programs, further studies regarding the carcinogenic roles of nonviral factors are required.
    Type of Medium: Online Resource
    ISSN: 1352-0504 , 1365-2893
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2007924-2
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  • 2
    In: Journal of Viral Hepatitis, Wiley, Vol. 28, No. 1 ( 2021-01), p. 95-104
    Abstract: Several prediction scores for the early detection of hepatocellular carcinoma (HCC) are available. We validated the predictive accuracy of age, albumin, sex, liver cirrhosis (AASL), RESCUE‐B, PAGE‐B and modified PAGE‐B (mPAGE‐B) scores in chronic hepatitis B (CHB) patients treated with entecavir (ETV) or tenofovir disoproxil fumarate (TDF). Between 2007 and 2014, 3171 patients were recruited (1645, ETV; 1517, TDF). The predictive accuracy of each prediction score was assessed. The mean age of the study population (1977 men; 1194 women) was 48.8 years. Liver cirrhosis was present in 1040 (32.8%) patients. During follow‐up (median, 58.2 months), 280 (8.8%) patients developed HCC; these patients were significantly older; more likely to be male; had significantly higher proportions of liver cirrhosis, hypertension and diabetes; and had significantly higher values for the four risk scores than those who did not develop HCC (all P   〈  .05). Older age (hazard ratio [HR] = 1.048), male sex (HR = 2.142), liver cirrhosis (HR = 3.144) and prolonged prothrombin time (HR = 2.589) were independently associated with an increased risk of HCC (all P   〈  .05), whereas a higher platelet count (HR = 0.996) was independently associated with a decreased risk of HCC ( P   〈  .05). The predictive accuracy of AASL score was the highest for 3‐ and 5‐year HCC predictions (areas under the curve [AUCs] = 0.818 and 0.816, respectively), followed by RESCUE‐B, PAGE‐B and mPAGE‐B scores (AUC = 0.780‐0.815 and 0.769‐0.814, respectively). In conclusion, four HCC prediction scores were assessed in Korean CHB patients treated with ETV or TDF. The AASL score showed the highest predictive accuracy.
    Type of Medium: Online Resource
    ISSN: 1352-0504 , 1365-2893
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2007924-2
    Library Location Call Number Volume/Issue/Year Availability
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  • 3
    In: Journal of Gastroenterology and Hepatology, Wiley, Vol. 37, No. 1 ( 2022-01), p. 200-207
    Abstract: Antiviral therapy (AVT) induces fibrosis regression in patients with chronic hepatitis B. We investigated long‐term effects of entecavir (ETV) versus tenofovir (TDF) on fibrotic burden. Methods Treatment‐naïve chronic hepatitis B patients who had begun ETV or TDF were recruited from four tertiary hospitals. The aspartate aminotransferase‐to‐platelet ratio index (APRI) and fibrosis index based on four factors (FIB‐4) were used to determine fibrotic burden. Results In the entire population ( n  = 3277), although patients treated with ETV had higher baseline APRI (1.71 vs 1.07, P   〈  0.001) and FIB‐4 (3.60 vs 2.80, P   〈  0.001) than those treated with TDF, significant fibrosis regression was identified during 6 years of AVT in both ETV (APRI, mean 1.71 → 0.48, P   〈  0.001; FIB‐4, mean 3.60 → 2.21, P   〈  0.001) and TDF groups (APRI, mean 1.07 → 0.43, P   〈  0.001; FIB‐4, mean 2.80 → 2.19, P   〈  0.001). In patients without cirrhosis ( n  = 2366), baseline APRI was significantly higher in ETV group than in TDF group (1.72 vs 0.97, P   〈  0.001); however, they became similar after 6 months. Similarly, baseline FIB‐4 was significantly higher in ETV group than in TDF group (3.25 vs 2.35, P   〈  0.001), but became similar from 4 to 6 years. In patients with cirrhosis ( n  = 911), baseline APRI (1.70 vs 1.34, P   〈  0.001) and FIB‐4 (4.62 vs 3.91, P  = 0.005) were higher in ETV group than in TDF, however, both parameters became statistically similar from 6 months to 6 years. Conclusion Significant regression of APRI and FIB‐4 was observed during long‐term ETV and TDF treatment. Despite higher baseline fibrotic burden in ETV group, fibrotic burden between the groups eventually converged through significant fibrosis regression after 1 to 4 years of AVT.
    Type of Medium: Online Resource
    ISSN: 0815-9319 , 1440-1746
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2006782-3
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