Evidence map›Paper›PMID 33988834›Full record

ArticleHepatology international2021

Statins associate with better clinical outcomes in chronic hepatitis B patients with HBsAg seroclearance.

Ka Shing Cheung, Lung Yi Mak, Lok Ka Lam, James Fung, Fen Liu, Wai Kay Seto, Man Fung Yuen

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Article in Hepatology international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.8field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. [Strategies of statins for the prevention and treatment of hepatocellular carcinoma].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025
    Review
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Ka Shing CheungDepartment of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
Lung Yi MakDepartment of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
Lok Ka LamDepartment of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
James FungDepartment of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
Fen LiuDepartment of Gastroenterology and Hepatology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Wai Kay SetoDepartment of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China. wkseto@hkucc.hku.hk.
Man Fung YuenDepartment of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China. mfyuen@hkucc.hku.hk.
Queen Mary Hospital · CNUniversity of Hong Kong · HKThe First Affiliated Hospital, Sun Yat-sen University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionWe aimed to describe long-term clinical outcomes in chronic hepatitis B (CHB) patients after HBsAg seroclearance, and identify factors that modify disease outcomes.

methodsCHB patients with HBsAg seroclearance occurring between 1986 and 2017 were recruited. Primary outcome was cirrhosis/hepatocellular carcinoma (HCC), and secondary outcomes were hepatic decompensation, liver-related death/transplantation, and all-cause mortality. Multivariable Cox model included demographics, prior antivirals, comorbidities, drugs (statins, metformin, proton-pump inhibitors, non-selective beta-blockers), and laboratory parameters (platelet, liver function test, prothrombin time, alpha-fetoprotein [AFP], anti-HBs). Statin users were propensity score matched (PSM) with non-users (1:2 ratio) for survival analysis of all outcomes.

resultsOf 913 patients with HBsAg seroclearance (male: 613 [67.1%]; median age: 53.4 years [18.5-87.0]), 129 (14.1%) were statin users. During median follow-up of 7.7 years (up to 29.1 years), 64/833 (7.7%) developed cirrhosis, 25/905 (2.8%) developed HCC, 3/913 (0.3%) underwent transplantation, and 76/913 (8.3%) died. Statins were associated with lower cirrhosis/HCC risk (adjusted hazard ratio [aHR]: 0.44; 95% CI 0.20-0.96; aHR for every 1-year increase in use: 0.85; 95% CI 0.75-0.97). Statin users had no hepatic decompensation or liver-related death/transplantation (vs 18/778 [2.3%] and 18/784 [2.3%] cases in statin non-users, respectively). Statins were also associated with lower all-cause mortality risk (aHR: 0.21; 95% CI 0.08-0.53). PSM yields consistent results for beneficial effects of statins (log-rank p < 0.05 for all outcomes). Other factors for cirrhosis/HCC included increasing age (aHR: 1.06), diabetes (aHR: 2.03), higher creatinine (aHR: 1.008), GGT > 50U/L (aHR: 3.25), and AFP > 9 ng/mL (aHR: 10.14).

conclusionPatients with HBsAg seroclearance have favorable long-term survival. However, liver-related adverse outcomes still develop, necessitating further investigations on beneficial effects of statins.

Indexed as

Hepatitis B, ChronicAdolescentAdultAgedAged, 80 and overCarcinoma, HepatocellularDNA, ViralFemaleHepatitis B Surface AntigensHepatitis B virusHumansHydroxymethylglutaryl-CoA Reductase InhibitorsLiver NeoplasmsMaleMiddle AgedYoung AdultDNA, ViralHepatitis B Surface AntigensHydroxymethylglutaryl-CoA Reductase InhibitorsAnti-HBsCHBHBVSeroclearanceS-lossStatins

Identifiers

PMID33988834
OpenAlexW3160936240

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.