Subclinical ascites does not affect the long-term prognosis in Hepatitis B virus-related cirrhosis patients receiving antivirals

Sun Young Yim, Jeong Hoon Lee, Hongkeun Ahn, Seung Up Kim, Sang Gyune Kim, Young Seok Kim, Jeong Han Kim, Won Hyeok Choe, Tae Yeob Kim, Young Kul Jung, Sang Jun Suh, Ki Tae Suk, Hyonggin An, Hyung Joon Yim, Yeon Seok Seo, Soon-Ho Um

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Background and Aims: This study evaluated the clinical significance of subclinical ascites in patients with hepatitis B virus-related cirrhosis treated with lamivudine (LMV) or entecavir (ETV). Methods: 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). Results: 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). Conclusions: Subclinical ascites did not affect prognosis in patients with hepatitis B virus-related cirrhosis receiving antiviral treatment.

Original languageEnglish
Pages (from-to)676-685
Number of pages10
JournalJournal of Clinical Gastroenterology
Issue number8
Publication statusPublished - 2016 Jan 1



  • chronic hepatitis B
  • liver cirrhosis
  • liver-related mortality
  • subclinical ascites

ASJC Scopus subject areas

  • Gastroenterology

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