Eight-year survival in chronic hepatitis B patients under long-term entecavir or tenofovir therapy is similar to the general population

George V. Papatheodoridis, Vana Sypsa, George Dalekos, Cihan Yurdaydin, Florian van Boemmel, Maria Buti, John Goulis, Jose Luis Calleja, Heng Chi, Spilios Manolakopoulos, Alessandro Loglio, Spyros Siakavellas, Nikolaos Gatselis, Onur Keskın, Maria Lehretz, Savvoula Savvidou, Juan de la Revilla, Bettina E. Hansen, Anastasia Kourikou, Ioannis VlachogiannakosKostantinos Galanis, Ramazan Idilman, Massimo Colombo, Rafael Esteban, Harry L.A. Janssen, Thomas Berg, Pietro Lampertico

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background & Aims: The effects of long-term antiviral therapy on survival have not been adequately assessed in chronic hepatitis B (CHB). In this 10-centre, ongoing cohort study, we evaluated the probability of survival and factors affecting survival in Caucasian CHB patients who received long-term entecavir/tenofovir therapy. Methods: We included 1,951 adult Caucasians with CHB, with or without compensated cirrhosis and without hepatocellular carcinoma (HCC) at baseline, who received entecavir/tenofovir for ≥12 months (median, six years). Kaplan–Meier estimates of cumulative survival over time were obtained. Standardized mortality ratios (SMRs) were calculated by comparing death rates with those in the Human Mortality Database. Results: The one-, five-, and eight-year cumulative probabilities were 99.7, 95.9, and 94.1% for overall survival, 99.9, 98.3, and 97.4% for liver-related survival, and 99.9, 97.8, and 95.8% for transplantation-free liver-related survival, respectively. Overall mortality was independently associated with older age and HCC development, liver-related mortality was associated with HCC development only, and transplantation-free liver-related mortality was independently associated with HCC development and lower platelet levels at baseline. Baseline cirrhosis was not independently associated with any type of mortality. Compared with the general population, in all CHB patients mortality was not significantly different (SMR 0.82), whereas it was lower in patients without HCC regardless of baseline cirrhosis (SMR 0.58) and was higher in patients who developed HCC (SMR 3.09). Conclusion: Caucasian patients with CHB and compensated liver disease who receive long-term entecavir/tenofovir therapy have excellent overall and liver-related eight-year survival, which is similar to that of the general population. HCC is the main factor affecting their overall mortality, and is the only factor affecting their liver-related mortality. Lay summary: Caucasian patients with chronic hepatitis B with or without compensated cirrhosis who receive long-term entecavir or tenofovir therapy have excellent overall eight-year survival, which is similar to that of the general population. Hepatocellular carcinoma is the main factor affecting their overall mortality, and is the only factor affecting liver-related mortality in this setting.

Original languageEnglish
Pages (from-to)1129-1136
JournalJournal of Hepatology
Volume68
Issue number6
DOIs
Publication statusPublished - 2018

Fingerprint

Tenofovir
Chronic Hepatitis B
Survival
Mortality
Population
Hepatocellular Carcinoma
Therapeutics
Fibrosis
Liver
entecavir
Liver Transplantation

Keywords

  • Antiviral therapy
  • Cirrhosis
  • Hepatitis B
  • Hepatocellular carcinoma
  • Liver transplantation

ASJC Scopus subject areas

  • Hepatology

Cite this

Eight-year survival in chronic hepatitis B patients under long-term entecavir or tenofovir therapy is similar to the general population. / Papatheodoridis, George V.; Sypsa, Vana; Dalekos, George; Yurdaydin, Cihan; van Boemmel, Florian; Buti, Maria; Goulis, John; Calleja, Jose Luis; Chi, Heng; Manolakopoulos, Spilios; Loglio, Alessandro; Siakavellas, Spyros; Gatselis, Nikolaos; Keskın, Onur; Lehretz, Maria; Savvidou, Savvoula; de la Revilla, Juan; Hansen, Bettina E.; Kourikou, Anastasia; Vlachogiannakos, Ioannis; Galanis, Kostantinos; Idilman, Ramazan; Colombo, Massimo; Esteban, Rafael; Janssen, Harry L.A.; Berg, Thomas; Lampertico, Pietro.

In: Journal of Hepatology, Vol. 68, No. 6, 2018, p. 1129-1136.

Research output: Contribution to journalArticle

Papatheodoridis, GV, Sypsa, V, Dalekos, G, Yurdaydin, C, van Boemmel, F, Buti, M, Goulis, J, Calleja, JL, Chi, H, Manolakopoulos, S, Loglio, A, Siakavellas, S, Gatselis, N, Keskın, O, Lehretz, M, Savvidou, S, de la Revilla, J, Hansen, BE, Kourikou, A, Vlachogiannakos, I, Galanis, K, Idilman, R, Colombo, M, Esteban, R, Janssen, HLA, Berg, T & Lampertico, P 2018, 'Eight-year survival in chronic hepatitis B patients under long-term entecavir or tenofovir therapy is similar to the general population', Journal of Hepatology, vol. 68, no. 6, pp. 1129-1136. https://doi.org/10.1016/j.jhep.2018.01.031
Papatheodoridis, George V. ; Sypsa, Vana ; Dalekos, George ; Yurdaydin, Cihan ; van Boemmel, Florian ; Buti, Maria ; Goulis, John ; Calleja, Jose Luis ; Chi, Heng ; Manolakopoulos, Spilios ; Loglio, Alessandro ; Siakavellas, Spyros ; Gatselis, Nikolaos ; Keskın, Onur ; Lehretz, Maria ; Savvidou, Savvoula ; de la Revilla, Juan ; Hansen, Bettina E. ; Kourikou, Anastasia ; Vlachogiannakos, Ioannis ; Galanis, Kostantinos ; Idilman, Ramazan ; Colombo, Massimo ; Esteban, Rafael ; Janssen, Harry L.A. ; Berg, Thomas ; Lampertico, Pietro. / Eight-year survival in chronic hepatitis B patients under long-term entecavir or tenofovir therapy is similar to the general population. In: Journal of Hepatology. 2018 ; Vol. 68, No. 6. pp. 1129-1136.
@article{964f6c74062e4b4da36387d2734e9e0a,
title = "Eight-year survival in chronic hepatitis B patients under long-term entecavir or tenofovir therapy is similar to the general population",
abstract = "Background & Aims: The effects of long-term antiviral therapy on survival have not been adequately assessed in chronic hepatitis B (CHB). In this 10-centre, ongoing cohort study, we evaluated the probability of survival and factors affecting survival in Caucasian CHB patients who received long-term entecavir/tenofovir therapy. Methods: We included 1,951 adult Caucasians with CHB, with or without compensated cirrhosis and without hepatocellular carcinoma (HCC) at baseline, who received entecavir/tenofovir for ≥12 months (median, six years). Kaplan–Meier estimates of cumulative survival over time were obtained. Standardized mortality ratios (SMRs) were calculated by comparing death rates with those in the Human Mortality Database. Results: The one-, five-, and eight-year cumulative probabilities were 99.7, 95.9, and 94.1{\%} for overall survival, 99.9, 98.3, and 97.4{\%} for liver-related survival, and 99.9, 97.8, and 95.8{\%} for transplantation-free liver-related survival, respectively. Overall mortality was independently associated with older age and HCC development, liver-related mortality was associated with HCC development only, and transplantation-free liver-related mortality was independently associated with HCC development and lower platelet levels at baseline. Baseline cirrhosis was not independently associated with any type of mortality. Compared with the general population, in all CHB patients mortality was not significantly different (SMR 0.82), whereas it was lower in patients without HCC regardless of baseline cirrhosis (SMR 0.58) and was higher in patients who developed HCC (SMR 3.09). Conclusion: Caucasian patients with CHB and compensated liver disease who receive long-term entecavir/tenofovir therapy have excellent overall and liver-related eight-year survival, which is similar to that of the general population. HCC is the main factor affecting their overall mortality, and is the only factor affecting their liver-related mortality. Lay summary: Caucasian patients with chronic hepatitis B with or without compensated cirrhosis who receive long-term entecavir or tenofovir therapy have excellent overall eight-year survival, which is similar to that of the general population. Hepatocellular carcinoma is the main factor affecting their overall mortality, and is the only factor affecting liver-related mortality in this setting.",
keywords = "Antiviral therapy, Cirrhosis, Hepatitis B, Hepatocellular carcinoma, Liver transplantation",
author = "Papatheodoridis, {George V.} and Vana Sypsa and George Dalekos and Cihan Yurdaydin and {van Boemmel}, Florian and Maria Buti and John Goulis and Calleja, {Jose Luis} and Heng Chi and Spilios Manolakopoulos and Alessandro Loglio and Spyros Siakavellas and Nikolaos Gatselis and Onur Keskın and Maria Lehretz and Savvoula Savvidou and {de la Revilla}, Juan and Hansen, {Bettina E.} and Anastasia Kourikou and Ioannis Vlachogiannakos and Kostantinos Galanis and Ramazan Idilman and Massimo Colombo and Rafael Esteban and Janssen, {Harry L.A.} and Thomas Berg and Pietro Lampertico",
year = "2018",
doi = "10.1016/j.jhep.2018.01.031",
language = "English",
volume = "68",
pages = "1129--1136",
journal = "Journal of Hepatology",
issn = "0168-8278",
publisher = "Elsevier B.V.",
number = "6",

}

TY - JOUR

T1 - Eight-year survival in chronic hepatitis B patients under long-term entecavir or tenofovir therapy is similar to the general population

AU - Papatheodoridis, George V.

AU - Sypsa, Vana

AU - Dalekos, George

AU - Yurdaydin, Cihan

AU - van Boemmel, Florian

AU - Buti, Maria

AU - Goulis, John

AU - Calleja, Jose Luis

AU - Chi, Heng

AU - Manolakopoulos, Spilios

AU - Loglio, Alessandro

AU - Siakavellas, Spyros

AU - Gatselis, Nikolaos

AU - Keskın, Onur

AU - Lehretz, Maria

AU - Savvidou, Savvoula

AU - de la Revilla, Juan

AU - Hansen, Bettina E.

AU - Kourikou, Anastasia

AU - Vlachogiannakos, Ioannis

AU - Galanis, Kostantinos

AU - Idilman, Ramazan

AU - Colombo, Massimo

AU - Esteban, Rafael

AU - Janssen, Harry L.A.

AU - Berg, Thomas

AU - Lampertico, Pietro

PY - 2018

Y1 - 2018

N2 - Background & Aims: The effects of long-term antiviral therapy on survival have not been adequately assessed in chronic hepatitis B (CHB). In this 10-centre, ongoing cohort study, we evaluated the probability of survival and factors affecting survival in Caucasian CHB patients who received long-term entecavir/tenofovir therapy. Methods: We included 1,951 adult Caucasians with CHB, with or without compensated cirrhosis and without hepatocellular carcinoma (HCC) at baseline, who received entecavir/tenofovir for ≥12 months (median, six years). Kaplan–Meier estimates of cumulative survival over time were obtained. Standardized mortality ratios (SMRs) were calculated by comparing death rates with those in the Human Mortality Database. Results: The one-, five-, and eight-year cumulative probabilities were 99.7, 95.9, and 94.1% for overall survival, 99.9, 98.3, and 97.4% for liver-related survival, and 99.9, 97.8, and 95.8% for transplantation-free liver-related survival, respectively. Overall mortality was independently associated with older age and HCC development, liver-related mortality was associated with HCC development only, and transplantation-free liver-related mortality was independently associated with HCC development and lower platelet levels at baseline. Baseline cirrhosis was not independently associated with any type of mortality. Compared with the general population, in all CHB patients mortality was not significantly different (SMR 0.82), whereas it was lower in patients without HCC regardless of baseline cirrhosis (SMR 0.58) and was higher in patients who developed HCC (SMR 3.09). Conclusion: Caucasian patients with CHB and compensated liver disease who receive long-term entecavir/tenofovir therapy have excellent overall and liver-related eight-year survival, which is similar to that of the general population. HCC is the main factor affecting their overall mortality, and is the only factor affecting their liver-related mortality. Lay summary: Caucasian patients with chronic hepatitis B with or without compensated cirrhosis who receive long-term entecavir or tenofovir therapy have excellent overall eight-year survival, which is similar to that of the general population. Hepatocellular carcinoma is the main factor affecting their overall mortality, and is the only factor affecting liver-related mortality in this setting.

AB - Background & Aims: The effects of long-term antiviral therapy on survival have not been adequately assessed in chronic hepatitis B (CHB). In this 10-centre, ongoing cohort study, we evaluated the probability of survival and factors affecting survival in Caucasian CHB patients who received long-term entecavir/tenofovir therapy. Methods: We included 1,951 adult Caucasians with CHB, with or without compensated cirrhosis and without hepatocellular carcinoma (HCC) at baseline, who received entecavir/tenofovir for ≥12 months (median, six years). Kaplan–Meier estimates of cumulative survival over time were obtained. Standardized mortality ratios (SMRs) were calculated by comparing death rates with those in the Human Mortality Database. Results: The one-, five-, and eight-year cumulative probabilities were 99.7, 95.9, and 94.1% for overall survival, 99.9, 98.3, and 97.4% for liver-related survival, and 99.9, 97.8, and 95.8% for transplantation-free liver-related survival, respectively. Overall mortality was independently associated with older age and HCC development, liver-related mortality was associated with HCC development only, and transplantation-free liver-related mortality was independently associated with HCC development and lower platelet levels at baseline. Baseline cirrhosis was not independently associated with any type of mortality. Compared with the general population, in all CHB patients mortality was not significantly different (SMR 0.82), whereas it was lower in patients without HCC regardless of baseline cirrhosis (SMR 0.58) and was higher in patients who developed HCC (SMR 3.09). Conclusion: Caucasian patients with CHB and compensated liver disease who receive long-term entecavir/tenofovir therapy have excellent overall and liver-related eight-year survival, which is similar to that of the general population. HCC is the main factor affecting their overall mortality, and is the only factor affecting their liver-related mortality. Lay summary: Caucasian patients with chronic hepatitis B with or without compensated cirrhosis who receive long-term entecavir or tenofovir therapy have excellent overall eight-year survival, which is similar to that of the general population. Hepatocellular carcinoma is the main factor affecting their overall mortality, and is the only factor affecting liver-related mortality in this setting.

KW - Antiviral therapy

KW - Cirrhosis

KW - Hepatitis B

KW - Hepatocellular carcinoma

KW - Liver transplantation

UR - http://www.scopus.com/inward/record.url?scp=85042941492&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042941492&partnerID=8YFLogxK

U2 - 10.1016/j.jhep.2018.01.031

DO - 10.1016/j.jhep.2018.01.031

M3 - Article

AN - SCOPUS:85042941492

VL - 68

SP - 1129

EP - 1136

JO - Journal of Hepatology

JF - Journal of Hepatology

SN - 0168-8278

IS - 6

ER -