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Regression of liver fibrosis in patients on hepatitis B therapy is associated with decreased liver-related events

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资源类型：
Pubmed体系：
作者：
Sun Yameng[1] * ; Chen Wei[2] * ; Chen Shuyan[1] * ; Wu Xiaoning[1] ; Zhang Xinxin[3] ; Zhang Lingyi[4] ; Zhao Hong[5] ; Xu Mingyi[6] ; Chen Yongpeng[7] ; Piao Hongxin[8] ; Li Ping[9] ; Li Lei[10] ; Jiang Wei[11] ; Li Xiaodong[12] ; Xing Huichun[13] ; Liu Xudong[14] ; Zhang Yuxi[15] ; Wang Bingqiong[1] ; Zhou Jialing[1] ; Meng Tongtong[1] ; Zhao Xinyan[1] ; Shao Chen[16] ; Kong Yuanyuan[17] ; Zhao Xinyu[17] ; Ou Xiaojuan[1] ; Liu Chenghai[18,*2] ; Jia Jidong[1,*1] ; You Hong[1,*1] ;
机构： [1]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of TranslationalMedicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, Beijing, China [2]Experimental andTranslational Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China [3]Department ofInfectious Diseases, Research Laboratory of Clinical Virology, National Research Center for Translational Medicine (Shanghai),Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China [4]Department of Hepatology, SecondHospital, Lanzhou University, Lanzhou, China [5]Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University,Beijing, China [6]Department of Gastroenterology and Hepatology, Shanghai General Hospital, Shanghai Jiao Tong UniversitySchool of Medicine, Shanghai, China [7]Department of Infectious Diseases, Nanfang Hospital, Southern Medical University,Guangzhou, Guangdong, China [8]Infectious Department, Affiliated Hospital of Yanbian University, Yanji, Jilin, China [9]Department of Hepatology, Tianjin Second People’s Hospital, Tianjin, China [10]Department of Gastroenterology andHepatology, Beijing You-an Hospital, Capital Medical University, Beijing, China [11]Department of Gastroenterology, ZhongshanHospital, Fudan University, Shanghai, China [12]Hepatic Disease Institute, Hubei Provincial Hospital of Traditional ChineseMedicine, Wuhan, China [13]Department of Hepatology, Division 3, Beijing Ditan Hospital, Capital Medical University, Beijing,China [14]Department of Liver Diseases, Ruikang Hospital, Guangxi Traditional Chinese Medicine University, Nanning, China [15]Department of Infectious Diseases, Ningxia People’s Hospital, Yinchuan, China [16]Department of Pathology, Beijing You-anHospital, Capital Medical University, Beijing, China [17]Clinical Epidemiology and EBM Unit, Beijing Friendship Hospital, CapitalMedical University, Beijing, China [18]Institute of Liver Diseases, Shuguang Hospital, Shanghai University of TraditionalChinese Medicine, Shanghai, China
出处：
DOI： 10.1016/j.cgh.2023.11.017
ISSN：

关键词： Liver Fibrosis Regression Liver-Related Events On-Treatment

摘要：
Liver fibrosis in patients with chronic hepatitis B (CHB) can regress with successful antiviral therapy. However, the long-term clinical benefits of fibrosis regression have not been fully elucidated. This study investigated the association between biopsy-proven fibrosis regression by P-I-R score and liver-related events (LREs) in CHB patients.Patients with on-treatment liver biopsy and significant fibrosis/cirrhosis (Ishak ≥ stage 3) were included in this analysis. Fibrosis regression was evaluated according to the P-I-R score of the Beijing Classification. LREs were defined as decompensations, hepatocellular carcinoma (HCC), liver transplantation, or death. Cox proportional hazards model was used to determine associations of fibrosis regression with LREs.A total of 733 patients with Ishak stage 3/4 (n = 456, 62.2%) and cirrhosis (Ishak stage 5/6, n = 277, 37.8%) by on-treatment liver biopsy were enrolled. According to the P-I-R score, fibrosis regression, indeterminate and progression were observed in 314 (42.8%), 230 (31.4%), and 189 (25.8%) patients, respectively. The 7-year cumulative incidence of LREs was 4.1%, 8.7%, and 18.1% in regression, indeterminate, and progression, respectively (Log-rank, P < .001). Compared to patients with fibrosis progression, those with fibrosis regression had a lower risk of LREs (adjusted HR = 0.40, 95%CI: 0.16-0.99, P = .047), followed by indeterminate group (adjusted HR = 0.86, 95%CI: 0.40 - 1.85, P = .691). Notably, this favorable association was also observed in patients with cirrhosis or low platelet counts (< 150×109/L).Antiviral therapy-induced liver fibrosis regression assessed by P-I-R score is associated with reduced liver-related events. This shows the utility of histologic fibrosis regression assessed by on-treatment P-I-R score as a surrogate endpoint for clinical events in patients with HBV-related fibrosis or early cirrhosis.Copyright © 2023 AGA Institute. Published by Elsevier Inc. All rights reserved.

基金：
This study was funded by National Science and Technology Major Project grant 2018ZX10302-204 and Q9Beijing Municipal Science and Technology Commission grant Z221100007422115.
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2022]版：
大类 | 1 区 医学
小类 | 1 区 胃肠肝病学
最新[2025]版：
大类 | 1 区 医学
小类 | 1 区 胃肠肝病学
第一作者：
第一作者机构： [1]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of TranslationalMedicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, Beijing, China
共同第一作者：
通讯作者：
通讯机构： [1]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of TranslationalMedicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, Beijing, China [18]Institute of Liver Diseases, Shuguang Hospital, Shanghai University of TraditionalChinese Medicine, Shanghai, China [*1]Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Road, Xi-Cheng District, Beijing 100050, China [*2]nstitute of Liver Diseases, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, 528 Zhang-heng Road, Pu-Dong District, Shanghai 201203, China
推荐引用方式(GB/T 7714)：
Sun Yameng,Chen Wei,Chen Shuyan,et al.Regression of liver fibrosis in patients on hepatitis B therapy is associated with decreased liver-related events[J].Clinical Gastroenterology And Hepatology : The Official Clinical Practice Journal Of The American Gastroenterological Association.2023,doi:10.1016/j.cgh.2023.11.017.
APA：
Sun Yameng,Chen Wei,Chen Shuyan,Wu Xiaoning,Zhang Xinxin...&You Hong.(2023).Regression of liver fibrosis in patients on hepatitis B therapy is associated with decreased liver-related events.Clinical Gastroenterology And Hepatology : The Official Clinical Practice Journal Of The American Gastroenterological Association,,
MLA：
Sun Yameng,et al."Regression of liver fibrosis in patients on hepatitis B therapy is associated with decreased liver-related events".Clinical Gastroenterology And Hepatology : The Official Clinical Practice Journal Of The American Gastroenterological Association .(2023)

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