Factors affecting the recovery of hepatic reserve after sustained virologic response by direct‐acting antiviral agents in chronic hepatitis C virus‐infected patients
Background and Aim Since the advent of direct‐acting antiviral (DAA) therapy, the total eradication of hepatitis C virus has been achievable with the recovery of hepatic reserve after achievement of sustained virologic response (SVR). Hence, here, we examined the factors affecting the recovery of he...
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| Veröffentlicht in: | Journal of gastroenterology and hepatology 2021-02, Vol.36 (2), p.367-375 |
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| creator | Nakajima, Tomoaki Karino, Yoshiyasu Hige, Shuhei Suii, Hirokazu Tatsumi, Ryoji Yamaguchi, Masakatsu Arakawa, Tomohiro Kuwata, Ysuaki Hasegawa, Takashi Toyota, Joji |
| description | Background and Aim
Since the advent of direct‐acting antiviral (DAA) therapy, the total eradication of hepatitis C virus has been achievable with the recovery of hepatic reserve after achievement of sustained virologic response (SVR). Hence, here, we examined the factors affecting the recovery of hepatic reserve.
Methods
We followed up 403 patients (male: 164, female: 239; genotype 1: 299, genotype 2: 104; median age: 69 years) for at least 3 years after they achieved SVR to DAA therapy. Of these patients, 75 (18.6%) had a history of hepatocellular carcinoma (HCC). Biochemical tests were periodically performed, and the hepatic reserve was evaluated based on the albumin–bilirubin grade. We examined background factors such as age, biochemical test results, HCC occurrence and portosystemic shunt by computed tomography.
Results
At the start of treatment, the albumin–bilirubin grades were grades 1, 2, and 3 in 241, 157, and 5 patients, respectively, and 3 years later, 117 of 162 (72%) patients with grade 2 or 3 improved to grade 1. Multivariate analysis identified the HCC occurrence after achievement of SVR (hazard ratio [HR]: 3.08, P |
| doi_str_mv | 10.1111/jgh.15280 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2447548016</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2447548016</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3530-717be30ea3d0bccaeaa473c658516948e791be92807f9ce1dca062a22cfe9b1c3</originalsourceid><addsrcrecordid>eNp1kc1u3CAURlHVqpmmXeQFKqRsmoUTsLExy2jU_ClSN-3ausbXM4w8MAU80ez6CH2NvFaeJLhOuqhUNkhwvsMVHyEnnJ3ztC42q_U5L_OavSELLgTLuBTVW7JgNS8zVXB1RD6EsGGMCSbL9-SoyJXismIL8ngFOjofKPQ96mjsisY1Uo_a7dEfqOvpGncQjU5nAf0eExnR0zCGCMZiR_fGu8GtZmLnbEDaHmhnkiM-_foNsxVsNImEgcIKbQzUWKrX3tmUm1-IJtDlZBtDihk7zZP009UU-Eje9TAE_PSyH5MfV1-_L2-y-2_Xt8vL-0wXZcEyyWWLBUMoOtZqDQggZKGrsi55pUSNUvEWVfos2SuNvNPAqhzyXPeoWq6LY_Jl9u68-zliiM3WBI3DABbdGJpcCFmKmvEqoaf_oBs3epumS5TKS1Xl9USdzZT2LgSPfbPzZgv-0HDWTP01qb_mT3-J_fxiHNstdn_J18IScDEDD2bAw_9Nzd31zax8BgWZqqo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2492596286</pqid></control><display><type>article</type><title>Factors affecting the recovery of hepatic reserve after sustained virologic response by direct‐acting antiviral agents in chronic hepatitis C virus‐infected patients</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Nakajima, Tomoaki ; Karino, Yoshiyasu ; Hige, Shuhei ; Suii, Hirokazu ; Tatsumi, Ryoji ; Yamaguchi, Masakatsu ; Arakawa, Tomohiro ; Kuwata, Ysuaki ; Hasegawa, Takashi ; Toyota, Joji</creator><creatorcontrib>Nakajima, Tomoaki ; Karino, Yoshiyasu ; Hige, Shuhei ; Suii, Hirokazu ; Tatsumi, Ryoji ; Yamaguchi, Masakatsu ; Arakawa, Tomohiro ; Kuwata, Ysuaki ; Hasegawa, Takashi ; Toyota, Joji</creatorcontrib><description>Background and Aim
Since the advent of direct‐acting antiviral (DAA) therapy, the total eradication of hepatitis C virus has been achievable with the recovery of hepatic reserve after achievement of sustained virologic response (SVR). Hence, here, we examined the factors affecting the recovery of hepatic reserve.
Methods
We followed up 403 patients (male: 164, female: 239; genotype 1: 299, genotype 2: 104; median age: 69 years) for at least 3 years after they achieved SVR to DAA therapy. Of these patients, 75 (18.6%) had a history of hepatocellular carcinoma (HCC). Biochemical tests were periodically performed, and the hepatic reserve was evaluated based on the albumin–bilirubin grade. We examined background factors such as age, biochemical test results, HCC occurrence and portosystemic shunt by computed tomography.
Results
At the start of treatment, the albumin–bilirubin grades were grades 1, 2, and 3 in 241, 157, and 5 patients, respectively, and 3 years later, 117 of 162 (72%) patients with grade 2 or 3 improved to grade 1. Multivariate analysis identified the HCC occurrence after achievement of SVR (hazard ratio [HR]: 3.08, P < 0.0138), male sex (HR: 3.45, P = 0.0143), hemoglobin level of <11.5 g/dL (HR: 4.19, P = 0.0157), the presence of a portosystemic shunt (HR: 3.07, P = 0.0349), and alanine aminotransferase levels <45 U/L (HR: 2.67, P = 0.0425) as factors inhibiting improvement to grade 1. However, old age was not an inhibitory factor.
Conclusion
Our results demonstrate that hepatic reserve could be improved even in elderly patients over a long course of time.</description><identifier>ISSN: 0815-9319</identifier><identifier>EISSN: 1440-1746</identifier><identifier>DOI: 10.1111/jgh.15280</identifier><identifier>PMID: 32991760</identifier><language>eng</language><publisher>Australia: Wiley Subscription Services, Inc</publisher><subject>Age ; Alanine ; Alanine transaminase ; ALBI score ; Albumin ; Antiviral agents ; Bilirubin ; Child–Pugh classification ; Computed tomography ; Direct acting antivirals ; Genotypes ; Hemoglobin ; Hepatic reserve ; Hepatitis ; Hepatitis C ; Hepatocellular carcinoma ; Multivariate analysis ; Sustained virologic response</subject><ispartof>Journal of gastroenterology and hepatology, 2021-02, Vol.36 (2), p.367-375</ispartof><rights>2020 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd</rights><rights>2020 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.</rights><rights>2021 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3530-717be30ea3d0bccaeaa473c658516948e791be92807f9ce1dca062a22cfe9b1c3</citedby><cites>FETCH-LOGICAL-c3530-717be30ea3d0bccaeaa473c658516948e791be92807f9ce1dca062a22cfe9b1c3</cites><orcidid>0000-0002-2255-7796</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgh.15280$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgh.15280$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32991760$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nakajima, Tomoaki</creatorcontrib><creatorcontrib>Karino, Yoshiyasu</creatorcontrib><creatorcontrib>Hige, Shuhei</creatorcontrib><creatorcontrib>Suii, Hirokazu</creatorcontrib><creatorcontrib>Tatsumi, Ryoji</creatorcontrib><creatorcontrib>Yamaguchi, Masakatsu</creatorcontrib><creatorcontrib>Arakawa, Tomohiro</creatorcontrib><creatorcontrib>Kuwata, Ysuaki</creatorcontrib><creatorcontrib>Hasegawa, Takashi</creatorcontrib><creatorcontrib>Toyota, Joji</creatorcontrib><title>Factors affecting the recovery of hepatic reserve after sustained virologic response by direct‐acting antiviral agents in chronic hepatitis C virus‐infected patients</title><title>Journal of gastroenterology and hepatology</title><addtitle>J Gastroenterol Hepatol</addtitle><description>Background and Aim
Since the advent of direct‐acting antiviral (DAA) therapy, the total eradication of hepatitis C virus has been achievable with the recovery of hepatic reserve after achievement of sustained virologic response (SVR). Hence, here, we examined the factors affecting the recovery of hepatic reserve.
Methods
We followed up 403 patients (male: 164, female: 239; genotype 1: 299, genotype 2: 104; median age: 69 years) for at least 3 years after they achieved SVR to DAA therapy. Of these patients, 75 (18.6%) had a history of hepatocellular carcinoma (HCC). Biochemical tests were periodically performed, and the hepatic reserve was evaluated based on the albumin–bilirubin grade. We examined background factors such as age, biochemical test results, HCC occurrence and portosystemic shunt by computed tomography.
Results
At the start of treatment, the albumin–bilirubin grades were grades 1, 2, and 3 in 241, 157, and 5 patients, respectively, and 3 years later, 117 of 162 (72%) patients with grade 2 or 3 improved to grade 1. Multivariate analysis identified the HCC occurrence after achievement of SVR (hazard ratio [HR]: 3.08, P < 0.0138), male sex (HR: 3.45, P = 0.0143), hemoglobin level of <11.5 g/dL (HR: 4.19, P = 0.0157), the presence of a portosystemic shunt (HR: 3.07, P = 0.0349), and alanine aminotransferase levels <45 U/L (HR: 2.67, P = 0.0425) as factors inhibiting improvement to grade 1. However, old age was not an inhibitory factor.
Conclusion
Our results demonstrate that hepatic reserve could be improved even in elderly patients over a long course of time.</description><subject>Age</subject><subject>Alanine</subject><subject>Alanine transaminase</subject><subject>ALBI score</subject><subject>Albumin</subject><subject>Antiviral agents</subject><subject>Bilirubin</subject><subject>Child–Pugh classification</subject><subject>Computed tomography</subject><subject>Direct acting antivirals</subject><subject>Genotypes</subject><subject>Hemoglobin</subject><subject>Hepatic reserve</subject><subject>Hepatitis</subject><subject>Hepatitis C</subject><subject>Hepatocellular carcinoma</subject><subject>Multivariate analysis</subject><subject>Sustained virologic response</subject><issn>0815-9319</issn><issn>1440-1746</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kc1u3CAURlHVqpmmXeQFKqRsmoUTsLExy2jU_ClSN-3ausbXM4w8MAU80ez6CH2NvFaeJLhOuqhUNkhwvsMVHyEnnJ3ztC42q_U5L_OavSELLgTLuBTVW7JgNS8zVXB1RD6EsGGMCSbL9-SoyJXismIL8ngFOjofKPQ96mjsisY1Uo_a7dEfqOvpGncQjU5nAf0eExnR0zCGCMZiR_fGu8GtZmLnbEDaHmhnkiM-_foNsxVsNImEgcIKbQzUWKrX3tmUm1-IJtDlZBtDihk7zZP009UU-Eje9TAE_PSyH5MfV1-_L2-y-2_Xt8vL-0wXZcEyyWWLBUMoOtZqDQggZKGrsi55pUSNUvEWVfos2SuNvNPAqhzyXPeoWq6LY_Jl9u68-zliiM3WBI3DABbdGJpcCFmKmvEqoaf_oBs3epumS5TKS1Xl9USdzZT2LgSPfbPzZgv-0HDWTP01qb_mT3-J_fxiHNstdn_J18IScDEDD2bAw_9Nzd31zax8BgWZqqo</recordid><startdate>202102</startdate><enddate>202102</enddate><creator>Nakajima, Tomoaki</creator><creator>Karino, Yoshiyasu</creator><creator>Hige, Shuhei</creator><creator>Suii, Hirokazu</creator><creator>Tatsumi, Ryoji</creator><creator>Yamaguchi, Masakatsu</creator><creator>Arakawa, Tomohiro</creator><creator>Kuwata, Ysuaki</creator><creator>Hasegawa, Takashi</creator><creator>Toyota, Joji</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2255-7796</orcidid></search><sort><creationdate>202102</creationdate><title>Factors affecting the recovery of hepatic reserve after sustained virologic response by direct‐acting antiviral agents in chronic hepatitis C virus‐infected patients</title><author>Nakajima, Tomoaki ; Karino, Yoshiyasu ; Hige, Shuhei ; Suii, Hirokazu ; Tatsumi, Ryoji ; Yamaguchi, Masakatsu ; Arakawa, Tomohiro ; Kuwata, Ysuaki ; Hasegawa, Takashi ; Toyota, Joji</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3530-717be30ea3d0bccaeaa473c658516948e791be92807f9ce1dca062a22cfe9b1c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age</topic><topic>Alanine</topic><topic>Alanine transaminase</topic><topic>ALBI score</topic><topic>Albumin</topic><topic>Antiviral agents</topic><topic>Bilirubin</topic><topic>Child–Pugh classification</topic><topic>Computed tomography</topic><topic>Direct acting antivirals</topic><topic>Genotypes</topic><topic>Hemoglobin</topic><topic>Hepatic reserve</topic><topic>Hepatitis</topic><topic>Hepatitis C</topic><topic>Hepatocellular carcinoma</topic><topic>Multivariate analysis</topic><topic>Sustained virologic response</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nakajima, Tomoaki</creatorcontrib><creatorcontrib>Karino, Yoshiyasu</creatorcontrib><creatorcontrib>Hige, Shuhei</creatorcontrib><creatorcontrib>Suii, Hirokazu</creatorcontrib><creatorcontrib>Tatsumi, Ryoji</creatorcontrib><creatorcontrib>Yamaguchi, Masakatsu</creatorcontrib><creatorcontrib>Arakawa, Tomohiro</creatorcontrib><creatorcontrib>Kuwata, Ysuaki</creatorcontrib><creatorcontrib>Hasegawa, Takashi</creatorcontrib><creatorcontrib>Toyota, Joji</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastroenterology and hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakajima, Tomoaki</au><au>Karino, Yoshiyasu</au><au>Hige, Shuhei</au><au>Suii, Hirokazu</au><au>Tatsumi, Ryoji</au><au>Yamaguchi, Masakatsu</au><au>Arakawa, Tomohiro</au><au>Kuwata, Ysuaki</au><au>Hasegawa, Takashi</au><au>Toyota, Joji</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors affecting the recovery of hepatic reserve after sustained virologic response by direct‐acting antiviral agents in chronic hepatitis C virus‐infected patients</atitle><jtitle>Journal of gastroenterology and hepatology</jtitle><addtitle>J Gastroenterol Hepatol</addtitle><date>2021-02</date><risdate>2021</risdate><volume>36</volume><issue>2</issue><spage>367</spage><epage>375</epage><pages>367-375</pages><issn>0815-9319</issn><eissn>1440-1746</eissn><abstract>Background and Aim
Since the advent of direct‐acting antiviral (DAA) therapy, the total eradication of hepatitis C virus has been achievable with the recovery of hepatic reserve after achievement of sustained virologic response (SVR). Hence, here, we examined the factors affecting the recovery of hepatic reserve.
Methods
We followed up 403 patients (male: 164, female: 239; genotype 1: 299, genotype 2: 104; median age: 69 years) for at least 3 years after they achieved SVR to DAA therapy. Of these patients, 75 (18.6%) had a history of hepatocellular carcinoma (HCC). Biochemical tests were periodically performed, and the hepatic reserve was evaluated based on the albumin–bilirubin grade. We examined background factors such as age, biochemical test results, HCC occurrence and portosystemic shunt by computed tomography.
Results
At the start of treatment, the albumin–bilirubin grades were grades 1, 2, and 3 in 241, 157, and 5 patients, respectively, and 3 years later, 117 of 162 (72%) patients with grade 2 or 3 improved to grade 1. Multivariate analysis identified the HCC occurrence after achievement of SVR (hazard ratio [HR]: 3.08, P < 0.0138), male sex (HR: 3.45, P = 0.0143), hemoglobin level of <11.5 g/dL (HR: 4.19, P = 0.0157), the presence of a portosystemic shunt (HR: 3.07, P = 0.0349), and alanine aminotransferase levels <45 U/L (HR: 2.67, P = 0.0425) as factors inhibiting improvement to grade 1. However, old age was not an inhibitory factor.
Conclusion
Our results demonstrate that hepatic reserve could be improved even in elderly patients over a long course of time.</abstract><cop>Australia</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32991760</pmid><doi>10.1111/jgh.15280</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-2255-7796</orcidid></addata></record> |
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| ispartof | Journal of gastroenterology and hepatology, 2021-02, Vol.36 (2), p.367-375 |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Age Alanine Alanine transaminase ALBI score Albumin Antiviral agents Bilirubin Child–Pugh classification Computed tomography Direct acting antivirals Genotypes Hemoglobin Hepatic reserve Hepatitis Hepatitis C Hepatocellular carcinoma Multivariate analysis Sustained virologic response |
| title | Factors affecting the recovery of hepatic reserve after sustained virologic response by direct‐acting antiviral agents in chronic hepatitis C virus‐infected patients |
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