Effect of antiviral therapy on prognosis of patients with decompensated hepatitis B cirrhosis undergoing transjugular intrahepatic portosystemic shunt

Objective To investigate the effect of antiviral therapy on the prognosis of patients with decompensated hepatitis B cirrhosis who underwent transjugular intrahepatic portosystemic shunt( TIPS). Methods The clinical data of 110 patients with decompensated hepatitis B cirrhosis who underwent TIPS to prevent variceal rebleeding from January 2008 to December 2011 were analyzed retrospectively,and based on whether they used antiviral drugs or not,these patients were divided into TIPS- antiviral drug group( 58 patients) and TIPS group( 52patients). The t- test or Wilcoxon rank sum test was applied for comparison of continuous data between the two groups,and the chi- square test was applied for comparison of categorical data between the two groups. The Kaplan- Meier survival analysis and log- rank test were performed to analyze the cumulative survival rate,rebleeding rate,stent patency rate,and incidence of hepatocellular carcinoma( HCC). Results The 1-,3-,and 5- year cumulative survival rates after TIPS in the TIPS- antiviral drug group versus the TIPS group were 93. 1%vs 88. 5%,86. 1% vs 64. 9%,and 77. 7% vs 59. 7%,respectively,and the TIPS- antiviral drug group had a significantly higher cumulative survival rate than the TIPS group( χ2= 6. 833,P = 0. 009). In the TIPS- antiviral drug group,the virologic response rate increased with the prolonged time of antiviral therapy. The cumulative variceal rebleeding rate,stent patency rate,and incidence of HCC showed no significant differences between the two groups( all P > 0. 05). Conclusion Antiviral therapy can improve the survival rate of patients with decompensated hepatitis B cirrhosis after TIPS.