Mo1033 Tumor Antigen Expression Differs in Hepatocellular Carcinoma (HCC) Between Viral Hepatitis and Non-Viral Hepatitis Patients

Abstract

Background/Aims: Spontaneous bacterial peritonitis (SBP) is a frequent complication of cirrhosis, associated with a poor long-term prognosis. The risk of SBP associated with proton pump inhibitor (PPI) use has been raised in advanced cirrhotic patients. However, those studies are limited by small series and/or case-control study design. This study aimed to determine whether PPI use is associated with SBP in a cohort composed of cirrhotic patients with ascites. Methods: This retrospective cohort study included 1,965 cirrhotic patients with ascites who was first diagnosed at Samsung Medical Hospital between Jan 2005 and Dec 2009. Propensity score matching generated a matched cohort composed of 886 patients. According to the PPI use (PPI group vs. non-PPI group), the SBP incidence was calculated in the each total study population and in the propensity score matched-cohort. Results: Of the 1,965 patients, 512 (32.9%) were included in PPI group. At baseline, PPI group showed lower platelet count (91.3 ± 54.2 x 103/mm3 vs. 103.4 ± 62.7 x 103/mm3; P<0.001), more prolonged prothrombin time (1.41 ± 0.43 INR vs. 1.35 ± 0.31 INR; P=0.001), and higher Child-Pugh score (8.0 ± 1.8 vs. 7.8 ± 1.6; P=0.041) than non-PPI group. PPI group showed higher SBP incidence rate than non-PPI group (10.3%/year vs. 5.9%/year; P=0.002). In the propensity score-matched cohort, baseline characteristics did not differ between the two groups. After matching, SBP incidence rate did not differ between the two groups (PPI group vs. non-PPI group, P=0.124) during a mean follow-up of 22.8 ± 24.5 months (range: 095.3 months). Conclusion: On the contrary to the current knowledge, our data suggest that PPI use is not a significant risk factor for SBP in cirrhotic patients with ascites.