title: The impact of newer nucleos(t)ide analogues on patients with hepatitis B decompensated cirrhosis.
abstract: OBJECTIVE
  Patients with HBV-related decompensated cirrhosis (HBV-DeCi) should be treated with potent nucleos(t)ide analogues (NA)[entecavir (ETV) or tenofovir (TDF)]. The aim was the evaluation of safety and efficacy in terms of changes in liver disease course in HBV-DeCi patients treated with ETV or TDF.
  
  
  METHODS
  In 52 HBV-DeCi patients clinical and laboratory data, including glomerular filtration rates (GFR), were recorded. The changes in MELD (DMELD) and Child-Pugh (DCTP) scores between baseline and after 6 months of treatment were evaluated. The independent factors associated with survival were evaluated.
  
  
  RESULTS
  31 patients under TDF and 21 under ETV were evaluated. During a median follow-up of 22.5 months (range: 6-68), there were no differences between the two groups in GFR and serum phosphate levels. At the end of follow up, in the TDF group, 2 patients died and 3 received liver transplantations (LT), while in the ETV group, 1 patient died and 3 received LT. In multivariable Cox regression analysis, DMELD was independently associated with the outcome in the total cohort (HR: 1.78, 95%C.I.:1.12-2.79, P=0.013) as well as in the subgroup of naïve (n=37) patients (HR: 1.8, 95%C.I.:1.19-4.5, P=0.03). Finally, in the non-hepatocellular carcinoma patients, the DCTP score was independently associated with the outcome in the total cohort (HR: 2.64, 95%C.I.: 1.21-7.29, P=0.015).
  
  
  CONCLUSIONS
  TDF and ETV appear to have similar renal safety profile in HBV-DeCi patients. DMELD score in the total cohort and DCTP score in non-HCC patients were independently associated with the outcome; these findings need confirmation in larger studies.
authors.affiliation: 4th Department of Internal Medicine, Medical School of Aristotle University, Hippokration General Hospital of Thessaloniki (Evangelos Cholongita, John Goulis, Evangelos Akriviadis), Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Cholongitas
authors.affiliation: Department of Gastroenterology, Athens University Medical School, Laiko General Hospital of Athens (George V. Papatheodoridis, John Vlachogiannakos, Anastasios Karlaftis), Greece.
authors.forename: George V
authors.initials: GV
authors.lastname: Papatheodoridis
authors.affiliation: 4th Department of Internal Medicine, Medical School of Aristotle University, Hippokration General Hospital of Thessaloniki (Evangelos Cholongita, John Goulis, Evangelos Akriviadis), Greece.
authors.forename: John
authors.initials: J
authors.lastname: Goulis
authors.affiliation: Department of Gastroenterology, Athens University Medical School, Laiko General Hospital of Athens (George V. Papatheodoridis, John Vlachogiannakos, Anastasios Karlaftis), Greece.
authors.forename: John
authors.initials: J
authors.lastname: Vlachogiannakos
authors.affiliation: First Department of Internal Medicine, General Hospital of Rhodes (Stylianos Karatapanis), Greece.
authors.forename: Stylianos
authors.initials: S
authors.lastname: Karatapanis
authors.affiliation: Department of Internal Medicine, Hippokration General Hospital of Athens (John Ketikoglou, George Kontos), Greece.
authors.forename: John
authors.initials: J
authors.lastname: Ketikoglou
authors.affiliation: 1st Pr. Department of Internal Medicine, AHEPA General Hospital, Aristotle University of Thessaloniki (Themistoklis Vasiliadis), Greece.
authors.forename: Themistoklis
authors.initials: T
authors.lastname: Vasiliadis
authors.affiliation: Department of Internal Medicine, Hippokration General Hospital of Athens (John Ketikoglou, George Kontos), Greece.
authors.forename: George
authors.initials: G
authors.lastname: Kontos
authors.affiliation: Department of Gastroenterology, Athens University Medical School, Laiko General Hospital of Athens (George V. Papatheodoridis, John Vlachogiannakos, Anastasios Karlaftis), Greece.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Karlaftis
authors.affiliation: 4th Department of Internal Medicine, Medical School of Aristotle University, Hippokration General Hospital of Thessaloniki (Evangelos Cholongita, John Goulis, Evangelos Akriviadis), Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Akriviadis
keywords: Keywords Decompensated cirrhosis; entecavir; nucleos(t)ide analogues; tenofovir