The impact of long-term potent antiviral therapy on the natural course of disease in patients with hepatitis B virusrelated cirrhosis


Kilic G., Guvenir T., BODAKÇİ E., MELEKOĞLU ELLİK Z., GÖKCAN H., İDİLMAN R.

Hepatology Forum, cilt.6, sa.4, ss.141-145, 2025 (Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 6 Sayı: 4
  • Basım Tarihi: 2025
  • Doi Numarası: 10.14744/hf.2024.2024.0069
  • Dergi Adı: Hepatology Forum
  • Derginin Tarandığı İndeksler: Scopus
  • Sayfa Sayıları: ss.141-145
  • Anahtar Kelimeler: Chronic hepatitis B, cirrhosis, entecavir, lamivudine, tenofovir disoproxil fumarate
  • Ankara Üniversitesi Adresli: Evet

Özet

Background and Aim: The present study compared the long-term efficacy of weak and potent antiviral treatments in patients with hepatitis B virus (HBV)-related cirrhosis. Materials and Methods: A total of 120 patients with HBV-related cirrhosis were enrolled. The primary outcome measure was viral suppression. A secondary outcome measure was to determine the development of decompensation or hepatocellular carcinoma (HCC). Results: The virological response (VR) was significantly better in patients treated with potent antiviral agents than in those treated with weaker antiviral agents over time (p<0.001). With intention-to-treat, the VR after 1 year, 2 years, 3 years, and 4 years of potent antiviral treatment was 69.7%, 77.0%, 82.2%, and 81.2%, respectively, while the VR with weak antiviral therapies was 50.0%, 41.6%, 37.5%, and 37.5%. HBeAg (Hepatitis B e-Antigen) loss was achieved in 30.4% of HBeAg-positive patients. None of the patients had experienced HBsAg loss while on antiviral treatment. New HCC developed in 10 patients. The cumulative probability of the development of HCC was 2.6% at 1 year, 6.8% at 2 years, and 8.7% at 3 and 5 years of antiviral therapy. MELD scores among patients treated with potent antiviral treatment significantly improved from baseline to week 60 (p=0.006). Antiviral therapies were well tolerated. Conclusion: Potent antiviral treatment effectively maintained VR in the long-term follow-up of patients with HBV-related cirrhosis. HCC may still develop, albeit at a lower rate in these patients.