Predictors of survival in hepatitis B virus related decompensated cirrhosis on tenofovir therapy: An Indian perspective

•MELD score >20 was the most robust predictor of mortality (58 times higher risk).•Probability of survival at 1st year and 2nd year was 0.947 and 0.833 respectively.•Tenofovir achieved >80% survival (two year) in HBV related decompensated cirrhosis.•CTP>10, MELD>20 and HBV DNA>7.4 log...

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Bibliographic Details
Published in:Antiviral research 2013-11, Vol.100 (2), p.300-305
Main Authors: Srivastava, Manjita, Rungta, Sumit, Dixit, V.K., Shukla, S.K., Singh, T.B., Jain, A.K.
Format: Article
Language:English
Subjects:
Adenine - analogs & derivatives
Adenine - therapeutic use
Adult
Aged
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antiviral agents
Antivirals
Bilirubin - blood
Biological and medical sciences
Creatinine - blood
Decompensated cirrhosis
DNA, Viral - blood
Female
Gastroenterology. Liver. Pancreas. Abdomen
Hepatitis B virus
Hepatitis B, Chronic - complications
Hepatitis B, Chronic - drug therapy
Hepatitis B, Chronic - mortality
Human viral diseases
Humans
India
Infectious diseases
Liver Cirrhosis - drug therapy
Liver Cirrhosis - mortality
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Longitudinal Studies
Male
Medical sciences
MELD
Middle Aged
Mortality
Organophosphonates - therapeutic use
Other diseases. Semiology
Pharmacology. Drug treatments
Platelet Count
Prognostic predictor
Prospective Studies
Severity of Illness Index
Survival
Survival Analysis
Tenofovir
Treatment Outcome
Viral diseases
Viral hepatitis
Viral Load
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Summary:•MELD score >20 was the most robust predictor of mortality (58 times higher risk).•Probability of survival at 1st year and 2nd year was 0.947 and 0.833 respectively.•Tenofovir achieved >80% survival (two year) in HBV related decompensated cirrhosis.•CTP>10, MELD>20 and HBV DNA>7.4 log copies/ml revealed poor post-treatment response.•Tenofovir was efficacious in paucity of viral breakthrough and clinical improvement. Decompensated cirrhosis has low survival rate compared to compensated state. Effective viral suppression due to antiviral therapy (tenofovir) has been shown to slow disease progression and may delay the burden of liver transplantation. We aimed to evaluate the usefulness of various prognostic indicators in predicting the 24-months survival in HBV related decompensated cirrhosis after tenofovir therapy and to evaluate the post-treatment outcome. Ninety-six HBV related decompensated patients on antiviral (tenofovir) therapy were prospectively studied for 24months survival and mortality. Cutoff levels for several prognostic indicators were generated by ROC. Prediction of overall probability of mortality was also calculated. The overall probability of survival observed at 12months was 0.947 whereas at 24months it was found to be 0.833. According to Cox proportional hazards model, the univariate analysis revealed cutoff of >7.4logcopies/ml for HBV DNA, >1.2mg/dl for serum creatinine, >3.7mg/dl for total bilirubin, ⩽0.75 for platelets count, >10 for CTP and >20 for MELD as predictors of poor survival. Multivariate analysis showed MELD score of >20 was the most robust predictor of mortality, with 58 times higher risk (HR: 58.73, p
ISSN:0166-3542
1872-9096
DOI:10.1016/j.antiviral.2013.08.020