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Conference Paper: Statins associated with better clinical outcomes in patients achieving HBsAg seroclearance: a long-term follow-up study
Title | Statins associated with better clinical outcomes in patients achieving HBsAg seroclearance: a long-term follow-up study |
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Authors | |
Issue Date | 2021 |
Publisher | Hong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/ |
Citation | The 26th Medical Research Conference, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, 16 January 2021. In Hong Kong Medical Journal, 2021, v. 27 n. 1, Suppl. 1, p. 10, abstract 5 How to Cite? |
Abstract | Introduction: Hepatitis B surface antigen (HBsAg) seroclearance is a clinical event that occurs either
spontaneously or during treatment with nucleos(t)ide analogue (NA) therapy or interferon. We aimed to
describe the long-term clinical course after HBsAg seroclearance, and to identify factors that modify disease outcomes, as clinical studies on these aspects are lacking.
Methods: Chronic hepatitis B 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, nonselective beta-blockers), and laboratory parameters (anti-HBs, platelet, liver function test, prothrombin time, and alpha-fetoprotein [AFP]). Statin users were propensity score matched (PSM) with non-users (1:2 ratio) for survival analysis of all outcomes.
Results: Of 913 patients with HBsAg seroclearance (613 male [67.1%]; median age 53.4 years [range, 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% confidence interval [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 nonusers, respectively). Statins 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), gammaglutamyl transferase >50 U/L (aHR=3.25) and AFP >9 ng/mL (aHR=10.14).
Conclusion: Long-term survival in patients with HBsAg seroclearance is good. However, liver-related adverse outcomes still develop, necessitating further investigations on beneficial effects of statins. |
Persistent Identifier | http://hdl.handle.net/10722/300717 |
ISSN | 2023 Impact Factor: 3.1 2023 SCImago Journal Rankings: 0.261 |
DC Field | Value | Language |
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dc.contributor.author | Cheung, KSM | - |
dc.contributor.author | Mak, LY | - |
dc.contributor.author | Fung, JYY | - |
dc.contributor.author | Liu, F | - |
dc.contributor.author | Seto, WKW | - |
dc.contributor.author | Yuen, RMF | - |
dc.date.accessioned | 2021-06-18T14:56:03Z | - |
dc.date.available | 2021-06-18T14:56:03Z | - |
dc.date.issued | 2021 | - |
dc.identifier.citation | The 26th Medical Research Conference, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, 16 January 2021. In Hong Kong Medical Journal, 2021, v. 27 n. 1, Suppl. 1, p. 10, abstract 5 | - |
dc.identifier.issn | 1024-2708 | - |
dc.identifier.uri | http://hdl.handle.net/10722/300717 | - |
dc.description.abstract | Introduction: Hepatitis B surface antigen (HBsAg) seroclearance is a clinical event that occurs either spontaneously or during treatment with nucleos(t)ide analogue (NA) therapy or interferon. We aimed to describe the long-term clinical course after HBsAg seroclearance, and to identify factors that modify disease outcomes, as clinical studies on these aspects are lacking. Methods: Chronic hepatitis B 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, nonselective beta-blockers), and laboratory parameters (anti-HBs, platelet, liver function test, prothrombin time, and alpha-fetoprotein [AFP]). Statin users were propensity score matched (PSM) with non-users (1:2 ratio) for survival analysis of all outcomes. Results: Of 913 patients with HBsAg seroclearance (613 male [67.1%]; median age 53.4 years [range, 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% confidence interval [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 nonusers, respectively). Statins 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), gammaglutamyl transferase >50 U/L (aHR=3.25) and AFP >9 ng/mL (aHR=10.14). Conclusion: Long-term survival in patients with HBsAg seroclearance is good. However, liver-related adverse outcomes still develop, necessitating further investigations on beneficial effects of statins. | - |
dc.language | eng | - |
dc.publisher | Hong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/ | - |
dc.relation.ispartof | Hong Kong Medical Journal | - |
dc.relation.ispartof | Medical Research Conference, The University of Hong Kong | - |
dc.rights | Hong Kong Medical Journal. Copyright © Hong Kong Academy of Medicine Press. | - |
dc.title | Statins associated with better clinical outcomes in patients achieving HBsAg seroclearance: a long-term follow-up study | - |
dc.type | Conference_Paper | - |
dc.identifier.email | Cheung, KSM: cks634@hku.hk | - |
dc.identifier.email | Mak, LY: lungyi@hku.hk | - |
dc.identifier.email | Fung, JYY: jfung@hkucc.hku.hk | - |
dc.identifier.email | Seto, WKW: wkseto@hku.hk | - |
dc.identifier.email | Yuen, RMF: mfyuen@hku.hk | - |
dc.identifier.authority | Cheung, KSM=rp02532 | - |
dc.identifier.authority | Mak, LY=rp02668 | - |
dc.identifier.authority | Fung, JYY=rp00518 | - |
dc.identifier.authority | Seto, WKW=rp01659 | - |
dc.identifier.authority | Yuen, RMF=rp00479 | - |
dc.description.nature | abstract | - |
dc.identifier.hkuros | 322899 | - |
dc.identifier.volume | 27 | - |
dc.identifier.issue | 1, Suppl. 1 | - |
dc.identifier.spage | 10, abstract 5 | - |
dc.identifier.epage | 10, abstract 5 | - |
dc.publisher.place | Hong Kong | - |