Regression of esophageal varices during entecavir treatment in patients with hepatitis-B-virus-related liver cirrhosis

Abstract

Recent studies suggest that liver cirrhosis is reversible after administering oral nucleos(t)ide analogue therapy to patients with hepatitis B virus (HBV) infection. However, few studies have addressed whether esophageal varices can regress after such therapy. We report a case of complete regression of esophageal varices during entecavir therapy in patients with HBV-related liver cirrhosis, suggesting that complications of liver cirrhosis such as esophageal varices can regress after the long-term suppression of HBV replication.

Keywords: Entecavir; Esophageal varices; Hepatitis B virus; Liver cirrhosis.

Figure 1.

Abdominal ultrasonographic findings. Intercostal and transverse sonograms (A, B) show coarse parenchymal echogenicity, surface nodularity, and a moderate amount of ascites in the perihepatic space. Subcostal oblique sonograms (C, D) show a large amount of ascites in the widened interlobar fissure, which is considered a typical finding of liver cirrhosis.

Figure 2.

Esophagogastroduodenoscopic findings. Straight to slightly enlarged (A, B) and tortuous varices (C) were observed on the lower esophagus. The esophageal varices had decreased to minimal varices after 2 years of entecavir therapy (D), and had completely disappeared after 4 years of entecavir therapy (E, F).