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Open Access Research

Effect of antiviral therapy on the survival and incidence of major complications in HBV-associated cirrhotic patients after splenectomy for hypersplenism and portal hypertension

Ningqiang Tian1, Zhengwen Liu13*, Mingbo Yang1, Zhu Li1, Guoyu Zhang1, Qunying Han1, Na Li1, Qianqian Zhu1, Yi Lv23, Yawen Wang1 and Fanfan Xing1

Author Affiliations

1 Department of Infectious Diseases, First Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, No. 277 Yanta West Road, Xi’ an, 710061, Shaanxi, China

2 Department of Hepatobiliary Surgery, First Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an, 710061, Shaanxi, China

3 Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi’ an, Shaanxi, 710061, China

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Virology Journal 2012, 9:273  doi:10.1186/1743-422X-9-273

Published: 16 November 2012

Abstract

Background

Splenectomy remains a common approach for the management of hypersplenism and portal hypertension in hepatitis B virus (HBV)-associated cirrhotic patients in China and some other Asian countries. The effects of antiviral therapy on the survival and occurrence of complications in asplenic HBV-associated cirrhotic patients are unknown. This study analyzed the effect of antiviral therapy on survival and occurrence of major complications in HBV-associated cirrhotic patients after splenectomy for hypersplenism and portal hypertension.

Results

Of the 57 eligible patients for analysis, 28 patients received nucleos(t)ide analogs (treatment group) for antiviral treatment after splenectomy, while 29 patients received no antiviral treatment (control group). After a median of 3 years and 9 months, the overall survival and complication-free survival in the treatment group were higher though not statistically significant than those in the control group. Multivariate analysis showed that antiviral treatment was associated with increased but not statistically significant overall survival (hazard ratio (HR): 2.272, 95% confidence interval (CI): 0.952–5.424, P = 0.064) and the antiviral treatment was significantly associated with increased complication-free survival of the patients (HR: 7.229, 95% CI: 1.271–41.117, P = 0.026). The complication-free survival in patients aged ≤ 40 years was higher than that in patients aged > 40 years in the antiviral treatment patients (P = 0.020).

Conclusions

Antiviral therapy initiating after splenectomy may reduce the incidence of complications and tend to improve the survival in asplenic HBV-associated cirrhotic patients, especially in younger patients, supporting the use of antiviral therapy in these patients after splenectomy.

Keywords:
Hepatitis B virus; Cirrhosis; Antiviral therapy; Splenectomy; Hypersplenism; Portal hypertension