Clinical outcomes in patients with hepatitis D, cirrhosis and persistent hepatitis B virus replication, and receiving long-term tenofovir or entecavir.

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  • Additional Information
    • Source:
      Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 8707234 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2036 (Electronic) Linking ISSN: 02692813 NLM ISO Abbreviation: Aliment Pharmacol Ther Subsets: MEDLINE
    • Publication Information:
      Publication: Oxford : Wiley-Blackwell
      Original Publication: [Oxford, OX] : Blackwell Scientific Publications, [c1987-
    • Subject Terms:
      Guanine/*analogs & derivatives ; Hepatitis B virus/*drug effects ; Hepatitis D, Chronic/*drug therapy ; Tenofovir/*therapeutic use; Adult ; Antiviral Agents/therapeutic use ; Carcinoma, Hepatocellular/epidemiology ; Female ; Follow-Up Studies ; Guanine/administration & dosage ; Hepatitis B/drug therapy ; Humans ; Liver Cirrhosis/drug therapy ; Liver Neoplasms/epidemiology ; Liver Transplantation/statistics & numerical data ; Male ; Middle Aged ; Prospective Studies ; Treatment Outcome
    • Abstract:
      Background: Suppression of hepatitis B virus (HBV) replication with nucelos(t)ide analogues should be considered for patients with chronic hepatitis D virus (HDV) infection and ongoing HBV replication.
      Aim: To verify the clinical outcome after long-term entecavir or tenofovir treatment in patients with advanced fibrosis/cirrhosis, ineligible to peg-interferon therapy.
      Methods: Patients were prospectively followed-up at 3-6 month intervals; measured outcomes were decompensation, hepatocellular carcinoma (HCC), liver transplant and liver related death. HBV monoinfected patients receiving the same treatment served as reference after 1:1 matching by age, gender, platelet count, albumin level, bilirubin and INR.
      Results: 56 HDV patients (48 with cirrhosis; median follow-up 50 months) were enrolled; all achieved HBV DNA suppression. Death or liver transplant occurred in 19 patients, with a rate (n/1000 patient-months) of 2.92 in HDV patients vs 0.38 in HBV monoinfected patients (P < 0.001); similarly, decompensation occurred at a rate of 1.53 vs 0.13 (P = 0.015), respectively, and the rate of HCC was almost thrice in HDV cohort (3.12 vs 1.12; P = 0.02) Platelet count, Child-Pugh score and marginally HDV infection were associated with HCC development.
      Conclusion: Patients with HDV infection and advanced liver disease maintain an increased risk of severe clinical events as compared with HBV monoinfected patients, during prolonged HBV DNA suppression with potent NA.
      (© 2019 John Wiley & Sons Ltd.)
    • Comments:
      Comment in: Aliment Pharmacol Ther. 2019 Aug;50(4):471. (PMID: 31359471)
      Comment in: Aliment Pharmacol Ther. 2020 Jan;51(2):314-315. (PMID: 31880015)
      Comment in: Aliment Pharmacol Ther. 2020 Jan;51(2):315-316. (PMID: 31880016)
      Comment in: Aliment Pharmacol Ther. 2020 Feb;51(4):482-483. (PMID: 31990393)
    • Accession Number:
      0 (Antiviral Agents)
      5968Y6H45M (entecavir)
      5Z93L87A1R (Guanine)
      99YXE507IL (Tenofovir)
    • Publication Date:
      Date Created: 20190223 Date Completed: 20200323 Latest Revision: 20200323
    • Publication Date:
      20240829
    • Accession Number:
      10.1111/apt.15188
    • Accession Number:
      30793345