أعرض في EDS

Statins associate with better clinical outcomes in chronic hepatitis B patients with HBsAg seroclearance

التفاصيل البيبلوغرافية
العنوان: Statins associate with better clinical outcomes in chronic hepatitis B patients with HBsAg seroclearance
المؤلفون: Fen Liu, Man-Fung Yuen, Lung-Yi Mak, Lok Ka Lam, Wai-Kay Seto, James Fung, Ka Shing Cheung
المصدر: Hepatology international. 15(4)
سنة النشر: 2021
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Hepatitis B virus, Cirrhosis, Statin, Carcinoma, Hepatocellular, Adolescent, medicine.drug_class, Gastroenterology, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Hepatitis B, Chronic, Internal medicine, medicine, Humans, Survival analysis, Aged, Aged, 80 and over, Hepatitis B Surface Antigens, Hepatology, medicine.diagnostic_test, business.industry, Hazard ratio, Liver Neoplasms, Middle Aged, medicine.disease, Transplantation, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, DNA, Viral, 030211 gastroenterology & hepatology, Female, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Liver function tests, business
الوصف: We aimed to describe long-term clinical outcomes in chronic hepatitis B (CHB) patients after HBsAg seroclearance, and identify factors that modify disease outcomes.CHB patients with HBsAg seroclearance occurring between 1986 and 2017 were recruited. Primary outcome was cirrhosis/hepatocellular carcinoma (HCC), and secondary outcomes were hepatic decompensation, liver-related death/transplantation, and all-cause mortality. Multivariable Cox model included demographics, prior antivirals, comorbidities, drugs (statins, metformin, proton-pump inhibitors, non-selective beta-blockers), and laboratory parameters (platelet, liver function test, prothrombin time, alpha-fetoprotein [AFP], anti-HBs). Statin users were propensity score matched (PSM) with non-users (1:2 ratio) for survival analysis of all outcomes.Of 913 patients with HBsAg seroclearance (male: 613 [67.1%]; median age: 53.4 years [18.5-87.0]), 129 (14.1%) were statin users. During median follow-up of 7.7 years (up to 29.1 years), 64/833 (7.7%) developed cirrhosis, 25/905 (2.8%) developed HCC, 3/913 (0.3%) underwent transplantation, and 76/913 (8.3%) died. Statins were associated with lower cirrhosis/HCC risk (adjusted hazard ratio [aHR]: 0.44; 95% CI 0.20-0.96; aHR for every 1-year increase in use: 0.85; 95% CI 0.75-0.97). Statin users had no hepatic decompensation or liver-related death/transplantation (vs 18/778 [2.3%] and 18/784 [2.3%] cases in statin non-users, respectively). Statins were also associated with lower all-cause mortality risk (aHR: 0.21; 95% CI 0.08-0.53). PSM yields consistent results for beneficial effects of statins (log-rank p 0.05 for all outcomes). Other factors for cirrhosis/HCC included increasing age (aHR: 1.06), diabetes (aHR: 2.03), higher creatinine (aHR: 1.008), GGT 50U/L (aHR: 3.25), and AFP 9 ng/mL (aHR: 10.14).Patients with HBsAg seroclearance have favorable long-term survival. However, liver-related adverse outcomes still develop, necessitating further investigations on beneficial effects of statins.
تدمد: 1936-0541
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d7a81b064fee8c1ad93ddecb75be306e
https://pubmed.ncbi.nlm.nih.gov/33988834
حقوق: CLOSED
رقم الأكسشن: edsair.doi.dedup.....d7a81b064fee8c1ad93ddecb75be306e
قاعدة البيانات: OpenAIRE
الوصف
تدمد:19360541