Role of etiological therapy in achieving recompensation of decompensated liver cirrhosis

Table 1 Efficacy of antiviral therapy in achieving recompensation of hepatitis B virus-related decompensated liver cirrhosis

Ref.	Research design, number of patients	CTP score, points	MELD score points	Antiviral therapy	Treatment period, SVR	Main results1
Nikolaidis et al[33]	Prospective, single-center, N = 20	B/C, 9.3 ± 2.0	16.2 ± 3.1	LAM	12-24-36 months, 55.0%	In 55% of patients, the CTP score decreased by more than 2 points, and in 45% of patients they reached CTP class A
Manolakopoulos et al[34]	Prospective, single-center, N = 19	A/B/C, 6 (5–12)	12 (7–26)	LAM	12 months, 78.9%	In 10 out of 13 patients with clinically significant portal hypertension and those who achieved SVR, there was a reduction in hepatic venous pressure gradient to less than 12 mmHg or 20% of the baseline
Shim et al[35]	Prospective, single-center, N = 55	B/C, 8.1 ± 1.7	11.5 ± 3.9	ETV	12 months, 89.1%	The CTP and MELD scores have improved. In 49% of patients, the CTP score values decreased by more than 2 points, and in 65.5% of patients they reached CTP class A
Liaw et al[36]	Randomized, open-label, comparative, N = 100, N = 91	B/C, ≥ 7, B/C, ≥ 7	17.1 (SE = 0.50), 15.3 (SE = 0.48)	ETV, ADV	12 months, 57.0%, 12 months, 20.0%	In 2/3 of the patients in both groups, the CTP score improved. The MELD score decreased by 2.6 points when treated with entecavir, and by 1.7 points when treated with adefovir
Jang et al[37]	Prospective, multicenter, N = 423	A/B/C, 8.7 ± 2.0	13.9 ± 6.4	LAM/ETV/ADV/clevudine/LdT	12 months, 57.9%	In 2/3 of the patients in both groups, the CTP score improved. The MELD score decreased by 2.6 points when treated with entecavir, and by 1.7 points when treated with adefovir
Lee et al[38]	Retrospective, multicenter, N = 57	B/C, 8.0 ± 1.5	13.4 ± 4.7	TDF	12 months, 70.2%	In 14.7% of patients, the initial values of the CTP score ≥ 7 decreased by more than 2 points, and in 12% of patients they reached CTP class A. Within 12 months of starting treatment, 33.9% of liver transplant candidates were excluded from the waiting list
Wang et al[39]	Prospective, multicenter, N = 283	B/C, 8.3 ± 1.9	13.4 ± 4.4	ETV	120 weeks, 92.2%	The CTP and MELD scores have improved. In 49.1% of patients, the initial values of the CTP score ≥ 7 decreased by more than 2 points, and in 68.4% of patients they reached CTP class A
Hui et al[40]	Retrospective, cohort, N = 1109	B, 6, 7	7.3 ± 4.5	ETV/TAF	12 months, N/A	For at least 12 months, 60.4% of patients had no ascites (off diuretics), encephalopathy (off lactulose/rifaximin) and recurrent gastroesophageal variceal bleeding. The serum albumin levels increased from 31.7 ± 6.4 to 42.4 ± 6.2, international normalized ratio values, serum levels of total bilirubin, ALT and aspartate aminotransferase decreased. The CTP and MELD scores improved: 5.77 ± 1.37 vs 8.33 ± 1.90 and 10.45 ± 4.58 vs 13.37 ± 4.44, respectively
Zhang et al[41]	Retrospective, two-center, cohort, N = 71	B/C, 8.5 ± 1.6	13.3 ± 4.3	ETV/TDF/TAF	12 months, N/A	Patients with decompensated LC who achieved recompensation showed a similar 5-year survival rate with those with compensated LC (76% and 89.3%, respectively)
Li et al[42]	Retrospective, cohort, N = 196	A/B/C	11.0 (8.0-15.0)	ETV/LAM + ADV/LdT + ADV/TDF/TAF	12 months, 78.1%	The cumulative incidence of hepatocellular carcinoma after 2 years, 4 years, and 6 years in patients with decompensated LC who achieved recompensation was the same as in those with compensated LC, which was 1.2%, 5.2%, 24.5%, and 1.3%, 5.4%, 20.0%, respectively. The rate of ascites regression was higher in SVR cohort when compared with that in non-SVR cohort. The serum ALT levels and load of serum hepatitis B virus DNA at baseline were predictors of ascites regression

¹The research results are statistically significant.

ADV: Adefovir dipivoxil; ALT: Alanine aminotransferase; CTP: Child-Turcotte-Pugh; ETV: Entecavir; LAM: Lamivudine; LC: Liver cirrhosis; LdT: Tebivudine; MELD: Model for end stage liver disease; N/A: Not available; SE: Standard error; SVR: Sustained virological response; TAF: Tenofovir alafenamide fumarate; TDF: Tenofovir disoproxil fumarate.