Published online Jan 14, 2017. doi: 10.3748/wjg.v23.i2.297
Peer-review started: October 7, 2016
First decision: November 9, 2016
Revised: November 22, 2016
Accepted: December 8, 2016
Article in press: December 8, 2016
Published online: January 14, 2017
To assess the effect of long-term oral nucleos(t)ide analogues (NUCs) therapy on liver volume change in patients with suppress hepatitis B virus (HBV)-related liver cirrhosis.
We reviewed the data of naïve patients with HBV-related liver cirrhosis, who had taken oral NUCs therapy, between 2003 and 2007 at Chonbuk University Hospital. We analyzed two consecutive sets of abdominal computerized tomography scans-one at the time of treatment initiation and another at the second-year follow-up. Liver volume was calculated by 3-dimensional liver extraction volumetry program.
A total of 55 patients (34 males) were included. There was 114.3 mL ± 167.8 mL (12.9% ± 17.9%) of increase in liver volume during the two years of NUCs therapy (993.8 mL ± 242.8 mL at baseline vs 1108.1 mL ± 263.3 mL at two-year follow-up, P < 0.001). The ratio of the measured baseline liver volume to the estimated standard liver volume was improved from 70.8% to 78.0%. An increase in liver volume was shown not only in patients with compensated cirrhosis (P = 0.046) but also in those with decompensated cirrhosis (P < 0.001). Significant factors for volume increases were Child-Turcotte-Pugh grade and model for end-stage liver disease score improvement without virological breakthrough. In multiple linear regression analysis, delta albumin and delta alanine aminotransferase levels showed a significant association with the increase in liver volume (P = 0.002 and 0.005, respectively).
Long-term oral NUCs therapy in patients with HBV-related liver cirrhosis lead to significant increase in liver volume assessed with 3-dimensional liver extraction volumetry program.
Core tip: Liver volume change may represent the hepatic functional and regenerative capacity. We inspected the effect of oral nucleos(t)ide analogues (NUCs) on liver volume in patients with hepatitis B virus-related cirrhosis. The result showed the increase in liver volume during two years of NUCs therapy and the volume increase was shown both in compensated and decompensated cirrhosis. The increase in liver volume was well correlated with several markers representing hepatic functional status. More volume increase may be attained regarding aggressive damage at baseline and marked improvement during the treatment period. Our data support the reversal of fibrosis and enhancement of liver regeneration of damaged liver in patients with liver cirrhosis after the treatment with NUCs.