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- Publisher Website: 10.1007/s12072-021-10197-4
- Scopus: eid_2-s2.0-85105849691
- PMID: 33988834
- WOS: WOS:000650538400001
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Article: Statins associate with better clinical outcomes in chronic hepatitis B patients with HBsAg seroclearance
Title | Statins associate with better clinical outcomes in chronic hepatitis B patients with HBsAg seroclearance |
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Authors | |
Keywords | S-loss Seroclearance Anti-HBs Statins HBV // CHB |
Issue Date | 2021 |
Publisher | Springer (India) Private Ltd. The Journal's web site is located at http://www.springer.com/medicine/internal/journal/12072 |
Citation | Hepatology International, 2021, v. 15 n. 4, p. 881-891 How to Cite? |
Abstract | Introduction:
We aimed to describe long-term clinical outcomes in chronic hepatitis B (CHB) patients after HBsAg seroclearance, and identify factors that modify disease outcomes.
Methods:
CHB 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, non-selective beta-blockers), and laboratory parameters (platelet, liver function test, prothrombin time, alpha-fetoprotein [AFP], anti-HBs). 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 (male: 613 [67.1%]; median age: 53.4 years [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% 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 non-users, respectively). Statins were 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), GGT > 50U/L (aHR: 3.25), and AFP > 9 ng/mL (aHR: 10.14).
Conclusion:
Patients with HBsAg seroclearance have favorable long-term survival. However, liver-related adverse outcomes still develop, necessitating further investigations on beneficial effects of statins. |
Persistent Identifier | http://hdl.handle.net/10722/300544 |
ISSN | 2023 Impact Factor: 5.9 2023 SCImago Journal Rankings: 1.813 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Cheung, KS | - |
dc.contributor.author | Mak, LY | - |
dc.contributor.author | Lam, LK | - |
dc.contributor.author | Fung, J | - |
dc.contributor.author | Liu, F | - |
dc.contributor.author | Seto, WK | - |
dc.contributor.author | Yuen, MF | - |
dc.date.accessioned | 2021-06-18T14:53:30Z | - |
dc.date.available | 2021-06-18T14:53:30Z | - |
dc.date.issued | 2021 | - |
dc.identifier.citation | Hepatology International, 2021, v. 15 n. 4, p. 881-891 | - |
dc.identifier.issn | 1936-0533 | - |
dc.identifier.uri | http://hdl.handle.net/10722/300544 | - |
dc.description.abstract | Introduction: We aimed to describe long-term clinical outcomes in chronic hepatitis B (CHB) patients after HBsAg seroclearance, and identify factors that modify disease outcomes. Methods: CHB 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, non-selective beta-blockers), and laboratory parameters (platelet, liver function test, prothrombin time, alpha-fetoprotein [AFP], anti-HBs). 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 (male: 613 [67.1%]; median age: 53.4 years [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% 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 non-users, respectively). Statins were 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), GGT > 50U/L (aHR: 3.25), and AFP > 9 ng/mL (aHR: 10.14). Conclusion: Patients with HBsAg seroclearance have favorable long-term survival. However, liver-related adverse outcomes still develop, necessitating further investigations on beneficial effects of statins. | - |
dc.language | eng | - |
dc.publisher | Springer (India) Private Ltd. The Journal's web site is located at http://www.springer.com/medicine/internal/journal/12072 | - |
dc.relation.ispartof | Hepatology International | - |
dc.rights | This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s12072-021-10197-4 | - |
dc.subject | S-loss | - |
dc.subject | Seroclearance | - |
dc.subject | Anti-HBs | - |
dc.subject | Statins | - |
dc.subject | HBV // CHB | - |
dc.title | Statins associate with better clinical outcomes in chronic hepatitis B patients with HBsAg seroclearance | - |
dc.type | Article | - |
dc.identifier.email | Cheung, KS: cks634@hku.hk | - |
dc.identifier.email | Mak, LY: lungyi@hku.hk | - |
dc.identifier.email | Fung, J: jfung@hkucc.hku.hk | - |
dc.identifier.email | Seto, WK: wkseto@hku.hk | - |
dc.identifier.email | Yuen, MF: mfyuen@hku.hk | - |
dc.identifier.authority | Cheung, KS=rp02532 | - |
dc.identifier.authority | Mak, LY=rp02668 | - |
dc.identifier.authority | Fung, J=rp00518 | - |
dc.identifier.authority | Seto, WK=rp01659 | - |
dc.identifier.authority | Yuen, MF=rp00479 | - |
dc.description.nature | postprint | - |
dc.identifier.doi | 10.1007/s12072-021-10197-4 | - |
dc.identifier.pmid | 33988834 | - |
dc.identifier.scopus | eid_2-s2.0-85105849691 | - |
dc.identifier.hkuros | 322875 | - |
dc.identifier.volume | 15 | - |
dc.identifier.issue | 4 | - |
dc.identifier.spage | 881 | - |
dc.identifier.epage | 891 | - |
dc.identifier.isi | WOS:000650538400001 | - |
dc.publisher.place | India | - |