Virological suppression does not prevent the development of hepatocellular carcinoma in HBeAg-negative chronic hepatitis B patients with cirrhosis receiving oral antiviral(s) starting with lamivudine monotherapy: results of the nationwide HEPNET. Greece cohort study

Papatheodoridis, George; Manolakopoulos, Spilios; Touloumi, Giota; Vourli, Georgia; Raptopoulou‐Gigi, M.; Vafiadis-Zoumbouli, I.; Vasiliadis, Themistoklis; Mimidis, Konstantinos; Gogos, Charalambos; Ketikoglou, I.; Manesis, Emanuel K.

doi:10.1136/gut.2010.221846

Cited by 172 publications

(139 citation statements)

References 32 publications

Supporting

Mentioning

128

Contrasting

Unclassified

Order By: Relevance

“…The incidence in non-cirrhotic HBV infected patients is less than 4%. This is in contrast to a lower incidence (1.4%) in HCV patients [4][5][6][7] . Prompt diagnosis of early or very early stage HCC is difficult due to the lack of specific symptoms and the relatively limited prognostic value of the serological and radiological approaches currently used for surveillance.…”

Section: Introductionmentioning

confidence: 45%

Cartilage oligomeric matrix protein: A novel non-invasive marker for assessing cirrhosis and risk of hepatocellular carcinoma

Norman¹

2015

WJH

View full text Add to dashboard Cite

AIM:To assess serum cartilage oligomeric matrix protein (COMP) as a marker of cirrhosis and risk of progression to hepatocellular carcinoma (HCC). METHODS: A COMP enzyme-linked immunosorbent ORIGINAL ARTICLEassay was used to test 187 patients with chronic liver diseases at the time point of first evaluation. The selected patients included 72 with chronic hepatitis B infection, 75 with chronic hepatitis C infection, 22 with primary biliary cirrhosis, 7 with autoimmune hepatitis type 1, and 11 with alcoholic liver disease. Demographic, biochemical, histological and clinical characteristics of the patients were recorded at the first evaluation. One hundred and forty-seven patients were followed for a median [interquartile range (IQR)] duration of 96.5 (102) mo. The clinical, biochemical and histological data, as well as the development of cirrhosis, HCC according to internationally accepted criteria and in case of death, a liver-related cause during the follow-up period, were recorded at the electronic database of our clinic. COMP determination was also performed in 43 healthy individuals who served as the control study group. RESULTS:COMP positivity (> 15 U/L) was detected in 22%-36% among chronic liver disease groups. Strikingly, almost 83% of COMP-positive patients were cirrhotic at baseline, independently of cause of liver disease. Among the patients who developed HCC during follow-up, 73.7% (14/19) were COMP positive at baseline. COMP positivity was significantly associated with older age (P < 0.001), advanced fibrosis (P = 0.001) and necroinflammatory activity (P = 0.001), higher aspartate aminotransferase (P < 0.001), alanine aminotransferase (P < 0.02), γ-glutamyl transpeptidase (P = 0.003), alkaline phosphatase (P = 0.001), bilirubin (P < 0.05), international normalized ratio (P = 0.002) and alpha-fetoprotein levels (P < 0.02), and lower albumin (P < 0.001), and platelet count (P = 0.008). COMP levels [median (IQR)] were significantly higher in cirrhotics compared to non-cirrhotics [13.8 (7.9) U/L vs 9.8 (4.6) U/L, respectively; P < 0.001]. On multivariate logistic regression analysis, COMP-positivity was independently associated only with cirrhosis (OR = 4.40, 95%CI: 1.33-14.69, P = 0.015). Kaplan-Meier analysis showed that COMP positivity was significantly associated with HCC development (P = 0.007) and higher incidence of liver-related death (P < 0.001).CONCLUSION: Elevated COMP levels are strongly associated with cirrhosis and HCC progression. Serum COMP is a new promising non-invasive biomarker for HCC risk assessment in surveillance programs.

show abstract

Section: Introductionmentioning

confidence: 45%

Cartilage oligomeric matrix protein: A novel non-invasive marker for assessing cirrhosis and risk of hepatocellular carcinoma

Norman¹

2015

WJH

View full text Add to dashboard Cite

show abstract

“…These oral antiviral agents are effective in restoring liver function and improving survival in patients with cirrhosis, especially when therapy is initiated early [82][83][84]. However, convincing effects preventing HCC development have yet to be demonstrated [85][86][87]. One possible explanation is that genetic events in some hepatocytes in cirrhotic nodules may have occurred before initiation of anti-viral therapy [88].…”

Section: Discussionmentioning

confidence: 94%

TGF-β signal shifting between tumor suppression and fibro-carcinogenesis in human chronic liver diseases

2013

View full text Add to dashboard Cite

“…A randomized study conducted by Liaw et al [31] demon- strated that lamivudine therapy for a median of 32 mo resulted in a decrease in the incidence of HCC in patients with advanced fibrosis, but not in patients with decompensated liver disease. Other studies have similarly failed to show any protective effect of lamivudine against the development of HCC in patients with decompensated liver disease [32,33] . The limitations of these studies include their relatively short follow-up periods and small sample sizes.…”

Section: Discussionmentioning

confidence: 96%

Liver transplantation for hepatitis B virus: Decreasing indication and changing trends

Al–Hamoudi¹

2015

WJG

View full text Add to dashboard Cite

Virological suppression does not prevent the development of hepatocellular carcinoma in HBeAg-negative chronic hepatitis B patients with cirrhosis receiving oral antiviral(s) starting with lamivudine monotherapy: results of the nationwide HEPNET. Greece cohort study

Cited by 172 publications

References 32 publications

Cartilage oligomeric matrix protein: A novel non-invasive marker for assessing cirrhosis and risk of hepatocellular carcinoma

Cartilage oligomeric matrix protein: A novel non-invasive marker for assessing cirrhosis and risk of hepatocellular carcinoma

TGF-β signal shifting between tumor suppression and fibro-carcinogenesis in human chronic liver diseases

Liver transplantation for hepatitis B virus: Decreasing indication and changing trends

Contact Info

Product

Resources

About