3-Dimensional liver volume assessment in patients with hepatitis B virus-related liver cirrhosis during long-term oral nucleos(t)ide analogues therapy

World J Gastroenterol. 2017 Jan 14;23(2):297-305. doi: 10.3748/wjg.v23.i2.297.

Abstract

Aim: 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.

Methods: 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.

Results: 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).

Conclusion: 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.

Keywords: Antiviral agents; Computer-assisted; Image processing; Liver cirrhosis; Liver regeneration.

MeSH terms

  • Administration, Oral
  • Adult
  • Alanine Transaminase / blood
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / therapeutic use*
  • End Stage Liver Disease / diagnosis
  • Female
  • Follow-Up Studies
  • Hepatitis B virus / isolation & purification*
  • Humans
  • Imaging, Three-Dimensional / methods
  • Liver / diagnostic imaging
  • Liver / pathology*
  • Liver / virology
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / diagnostic imaging
  • Liver Cirrhosis / drug therapy*
  • Liver Cirrhosis / virology
  • Liver Regeneration / drug effects*
  • Long-Term Care
  • Male
  • Middle Aged
  • Nucleosides / administration & dosage
  • Nucleosides / analysis*
  • Nucleosides / therapeutic use
  • Nucleotides / administration & dosage
  • Nucleotides / analysis*
  • Nucleotides / therapeutic use
  • Organ Size / drug effects
  • Retrospective Studies
  • Serum Albumin / analysis
  • Severity of Illness Index
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Viral Load / drug effects

Substances

  • Antiviral Agents
  • Nucleosides
  • Nucleotides
  • Serum Albumin
  • Alanine Transaminase