title: Subclinical Ascites Does Not Affect the Long-term Prognosis in Hepatitis B Virus-related Cirrhosis Patients Receiving Antivirals.
abstract: This study evaluated the clinical significance of subclinical ascites in patients with hepatitis B virus-related cirrhosis treated with lamivudine (LMV) or entecavir (ETV).
  
  
  
  This multicenter retrospective study involved 8 hospitals. Patients were classified by degree of ascites: (1) no ascites (no ascites on imaging, no diuretics), (2) subclinical ascites (small amount of ascites on imaging, no diuretics), and (3) clinical ascites (moderate to severe ascites or diuretics).
  
  
  
  Out of 501 patients, 336 (68%), 51 (10%), and 114 (23%) patients were classified as no-ascites, subclinical ascites, and clinical ascites, respectively. In all, 100 (20%) and 401 (80%) were treated with LMV and ETV, respectively. Over 58±24 months of follow-up, 105 patients (21%) developed hepatocellular carcinoma. The cumulative incidence of hepatocellular carcinoma did not differ between LMV-treated and ETV-treated patients (P=0.61); it was higher in the clinical-ascites group than the no-ascites (P=0.054) and subclinical-ascites (P=0.03) groups, but it was comparable between the latter 2 (P=0.225). Forty-five patients (9%) died during follow-up. Survival was significantly shorter in the clinical-ascites group than the other 2 (both P<0.005), but it was comparable between no-ascites and subclinical-ascites groups (P=0.444). Multivariate analysis showed that mortality was significantly associated with prothrombin time [hazard ratio (HR)=2.42; 95% confidence interval (CI), 1.59-3.70], serum albumin (HR=0.54; 95% CI, 0.29-0.99), and presence of clinical ascites (HR=3.58; 95% CI, 1.54-8.30).
  
  
  
  Subclinical ascites did not affect prognosis in patients with hepatitis B virus-related cirrhosis receiving antiviral treatment.
authors.affiliation: Departments of *Internal Medicine **Biostatistics, Korea University College of Medicine †Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine ‡Department of Internal Medicine, Yonsei University College of Medicine ∥Department of Internal Medicine, Konkuk University College of Medicine, Seoul §Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon ¶Institue of Medical Science, Hanyang University College of Medicine, Guri #Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Yim
authors.forename: Jeong-Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Hongkeun
authors.initials: H
authors.lastname: Ahn
authors.forename: Seung Up
authors.initials: SU
authors.lastname: Kim
authors.forename: Sang Gyune
authors.initials: SG
authors.lastname: Kim
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Kim
authors.forename: Jeong Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Won Hyeok
authors.initials: WH
authors.lastname: Choe
authors.forename: Tae Yeob
authors.initials: TY
authors.lastname: Kim
authors.forename: Young Kul
authors.initials: YK
authors.lastname: Jung
authors.forename: Sang Jun
authors.initials: SJ
authors.lastname: Suh
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Suk
authors.forename: Hyunggin
authors.initials: H
authors.lastname: An
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Yim
authors.forename: Yeon Seok
authors.initials: YS
authors.lastname: Seo
authors.forename: Soon Ho
authors.initials: SH
authors.lastname: Um
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D001201:Ascites / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D015994:Incidence; D019259:Lamivudine / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000150:complications* / Q000401:mortality / Q000821:virology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000821:virology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011517:Prothrombin Time; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism
chemical_list: D000998:Antiviral Agents; D012709:Serum Albumin; D019259:Lamivudine; C413685:entecavir; D006147:Guanine