Long-term endoscopic surveillance in HBV compensated cirrhotic patients treated with Tenofovir or Entecavir for 11 years.
Farina, E
Loglio, A
Tosetti, G
Degasperi, E
Viganò, M
Gentile, C
Monico, S
Perbellini, R
Borghi, M
Facchetti, F
Uceda Renteria, SC
Ceriotti, F
Cerini, F
Primignani, M
Lampertico, P
- Publisher:
- WILEY
- Publication Type:
- Journal Article
- Citation:
- Aliment Pharmacol Ther, 2023, 57, (12), pp. 1407-1416
- Issue Date:
- 2023-06
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Aliment Pharmacol Ther - 2023 - Farina - Long‐term endoscopic surveillance in HBV compensated cirrhotic patients treated.pdf | Published version | 668.07 kB | Adobe PDF |
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Full metadata record
Field | Value | Language |
---|---|---|
dc.contributor.author | Farina, E | |
dc.contributor.author | Loglio, A | |
dc.contributor.author | Tosetti, G | |
dc.contributor.author | Degasperi, E | |
dc.contributor.author | Viganò, M | |
dc.contributor.author |
Gentile, C https://orcid.org/0000-0002-3689-4275 |
|
dc.contributor.author | Monico, S | |
dc.contributor.author | Perbellini, R | |
dc.contributor.author | Borghi, M | |
dc.contributor.author | Facchetti, F | |
dc.contributor.author | Uceda Renteria, SC | |
dc.contributor.author | Ceriotti, F | |
dc.contributor.author | Cerini, F | |
dc.contributor.author | Primignani, M | |
dc.contributor.author | Lampertico, P | |
dc.date.accessioned | 2024-04-29T08:12:07Z | |
dc.date.available | 2023-02-27 | |
dc.date.available | 2024-04-29T08:12:07Z | |
dc.date.issued | 2023-06 | |
dc.identifier.citation | Aliment Pharmacol Ther, 2023, 57, (12), pp. 1407-1416 | |
dc.identifier.issn | 0269-2813 | |
dc.identifier.issn | 1365-2036 | |
dc.identifier.uri | http://hdl.handle.net/10453/178467 | |
dc.description.abstract | BACKGROUND: Long-term administration of TDF/ETV in patients with HBV-related compensated cirrhosis reduces HCC and decompensation events but the effect of this regimen on development/regression of oesophageal varices (EV) is currently unknown. AIM: To assess the risk of EV development/progression in this population. METHODS: A total of 186 Caucasian HBV-monoinfected compensated cirrhotics were enrolled in a long-term cohort study from TDF/ETV introduction. Upper GI endoscopies were performed according to Baveno recommendations. Primary endpoint was development/progression of oesophageal/gastric varices over time. RESULTS: At TDF/ETV start, median age was 61 years, 80% males, 60% HBV-DNA undetectable, 63% NUCs previously exposed, 73% normal ALT, 40% platelets <150,000/mmc and 25 (13%) with low-risk varices (LRV). During 11 years of antiviral therapy and 666 endoscopies performed, 9 patients either developed or had a progression of oesophageal or gastric varices with an 11-year cumulative probability of 5.1% (95% CI 3-10%); no patient bled. Out of 161 patients without EV at baseline, the 11-year probably was 4.5% with all varices developing within the first six years of treatment. In 25 patients with LRV at baseline, the 11-year probability of progression or regression was 9.3% and 58%, respectively. Only baseline platelet count (HR 0.96, p = 0.028) was associated with LRV development at multivariate analysis: platelet ≤90,000/mmc (AUROC 0.70) had 98.1% specificity, 42.9% sensitivity, 50% PPV for LRV onset. CONCLUSIONS: In compensated cirrhotic patients under long-term effective TDF/ETV treatment, the 11-year risk of developing/progressing EV is negligible, thus challenging the current endoscopic surveillance recommendations in patients without EV at baseline. | |
dc.format | Print-Electronic | |
dc.language | eng | |
dc.publisher | WILEY | |
dc.relation.ispartof | Aliment Pharmacol Ther | |
dc.relation.isbasedon | 10.1111/apt.17463 | |
dc.rights | info:eu-repo/semantics/closedAccess | |
dc.subject | 1103 Clinical Sciences, 1115 Pharmacology and Pharmaceutical Sciences | |
dc.subject.classification | Gastroenterology & Hepatology | |
dc.subject.classification | 3202 Clinical sciences | |
dc.subject.classification | 3214 Pharmacology and pharmaceutical sciences | |
dc.subject.mesh | Male | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Female | |
dc.subject.mesh | Tenofovir | |
dc.subject.mesh | Antiviral Agents | |
dc.subject.mesh | Hepatitis B virus | |
dc.subject.mesh | Cohort Studies | |
dc.subject.mesh | Carcinoma, Hepatocellular | |
dc.subject.mesh | Esophageal and Gastric Varices | |
dc.subject.mesh | Liver Neoplasms | |
dc.subject.mesh | Liver Cirrhosis | |
dc.subject.mesh | Varicose Veins | |
dc.subject.mesh | Treatment Outcome | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Hepatitis B virus | |
dc.subject.mesh | Carcinoma, Hepatocellular | |
dc.subject.mesh | Liver Neoplasms | |
dc.subject.mesh | Esophageal and Gastric Varices | |
dc.subject.mesh | Liver Cirrhosis | |
dc.subject.mesh | Varicose Veins | |
dc.subject.mesh | Antiviral Agents | |
dc.subject.mesh | Treatment Outcome | |
dc.subject.mesh | Cohort Studies | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Female | |
dc.subject.mesh | Male | |
dc.subject.mesh | Tenofovir | |
dc.subject.mesh | Male | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Female | |
dc.subject.mesh | Tenofovir | |
dc.subject.mesh | Antiviral Agents | |
dc.subject.mesh | Hepatitis B virus | |
dc.subject.mesh | Cohort Studies | |
dc.subject.mesh | Carcinoma, Hepatocellular | |
dc.subject.mesh | Esophageal and Gastric Varices | |
dc.subject.mesh | Liver Neoplasms | |
dc.subject.mesh | Liver Cirrhosis | |
dc.subject.mesh | Varicose Veins | |
dc.subject.mesh | Treatment Outcome | |
dc.title | Long-term endoscopic surveillance in HBV compensated cirrhotic patients treated with Tenofovir or Entecavir for 11 years. | |
dc.type | Journal Article | |
utslib.citation.volume | 57 | |
utslib.location.activity | England | |
utslib.for | 1103 Clinical Sciences | |
utslib.for | 1115 Pharmacology and Pharmaceutical Sciences | |
pubs.organisational-group | University of Technology Sydney | |
pubs.organisational-group | University of Technology Sydney/Faculty of Engineering and Information Technology | |
pubs.organisational-group | University of Technology Sydney/Strength - CHT - Health Technologies | |
pubs.organisational-group | University of Technology Sydney/Faculty of Engineering and Information Technology/School of Biomedical Engineering | |
utslib.copyright.status | closed_access | * |
dc.date.updated | 2024-04-29T08:12:04Z | |
pubs.issue | 12 | |
pubs.publication-status | Published | |
pubs.volume | 57 | |
utslib.citation.issue | 12 |
Abstract:
BACKGROUND: Long-term administration of TDF/ETV in patients with HBV-related compensated cirrhosis reduces HCC and decompensation events but the effect of this regimen on development/regression of oesophageal varices (EV) is currently unknown. AIM: To assess the risk of EV development/progression in this population. METHODS: A total of 186 Caucasian HBV-monoinfected compensated cirrhotics were enrolled in a long-term cohort study from TDF/ETV introduction. Upper GI endoscopies were performed according to Baveno recommendations. Primary endpoint was development/progression of oesophageal/gastric varices over time. RESULTS: At TDF/ETV start, median age was 61 years, 80% males, 60% HBV-DNA undetectable, 63% NUCs previously exposed, 73% normal ALT, 40% platelets <150,000/mmc and 25 (13%) with low-risk varices (LRV). During 11 years of antiviral therapy and 666 endoscopies performed, 9 patients either developed or had a progression of oesophageal or gastric varices with an 11-year cumulative probability of 5.1% (95% CI 3-10%); no patient bled. Out of 161 patients without EV at baseline, the 11-year probably was 4.5% with all varices developing within the first six years of treatment. In 25 patients with LRV at baseline, the 11-year probability of progression or regression was 9.3% and 58%, respectively. Only baseline platelet count (HR 0.96, p = 0.028) was associated with LRV development at multivariate analysis: platelet ≤90,000/mmc (AUROC 0.70) had 98.1% specificity, 42.9% sensitivity, 50% PPV for LRV onset. CONCLUSIONS: In compensated cirrhotic patients under long-term effective TDF/ETV treatment, the 11-year risk of developing/progressing EV is negligible, thus challenging the current endoscopic surveillance recommendations in patients without EV at baseline.
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