Entecavir treatment reduces hepatic events and deaths in chronic hepatitis B patients With liver cirrhosis

作者：Grace Lai‐Hung Wong, Henry Lik‐Yuen Chan, Christy Wing–Hin Mak, Stanley King–Yeung Lee, Zoe Man–Yi Ip, Andrew Ting–Ho Lam, Henry Wing–Hang Iu, Joyce May-Sum Leung, Jennifer Wing-Yan Lai, Angeline Oi–Shan Lo, Hoi–Yun Chan, Vincent Wai‐Sun Wong · 发表于：Hepatology · 年份：2013 · DOI：10.1002/hep.26301 · 被引用次数：489 · 研究领域：Hepatitis B Virus Studies、Viral gastroenteritis research and epidemiology、Hepatitis C virus research

UNLABELLED: Entecavir is a potent antiviral agent with high genetic barrier to resistance, hence it is currently recommended as first-line antiviral therapy for chronic hepatitis B (CHB). The aim of this study was to investigate the efficacy of entecavir on clinical outcomes and deaths. It was a retrospective-prospective cohort study based on two cohorts of patients. The entecavir cohort included consecutive CHB patients who had received entecavir 0.5 mg/day for at least 12 months. The historical control cohort included untreated patients recruited since 1997 who underwent routine clinical care. The primary outcome was the 5-year cumulative probability of hepatic events, defined as any cirrhotic complications, hepatocellular carcinoma (HCC), and/or liver-related mortality. A total of 1,446 entecavir-treated patients (72% men; age, 51 ± 12 years; follow-up, 36 ± 13 months) and 424 treatment-naïve patients (65% men; age, 41 ± 13 years; follow-up, 114 ± 31 months) were studied. Overall, there was no difference in hepatic events between the entecavir and control cohorts. Among patients with liver cirrhosis (482 entecavir-treated, 69 treatment-naïve), entecavir-treated patients had reduced risks of all clinical outcomes when compared with treatment-naïve patients with cirrhosis after adjusted for model for end-stage liver disease score: hepatic events (hazard ratio [HR], 0.51; 95% confidence interval [CI], 0.34-0.78; P = 0.002), HCC (HR, 0.55; 95% CI, 0.31-0.99; P = 0.049), liver-...