标题: [英语,临床]Suppressive effects of entecavir on hepatitis B virus and hepat [打印本页] 作者: StephenW 时间: 2011-5-21 04:21 标题: [英语,临床]Suppressive effects of entecavir on hepatitis B virus and hepat
Journal of Gastroenterology and Hepatology
Accepted Article (Accepted, unedited articles published online for future
issues)
Abstract
Background/Aim: We investigated the efficacy and effectiveness of entecavir
in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients.
Methods: We enrolled 231 nucleoside-naïve chronic hepatitis B (CHB)
patients primarily treated with entecavir 0.5 mg/day for at least 6 months
in our institution. Of these, 71 patients had HCC at the start of entecavir
treatment (HCC group) and 160 did not (non-HCC group). We compared
antiviral responses to entecavir in the two groups, and evaluated the
effects of entecavir on the clinical outcomes of curatively-treated HCC
patients.
Results: The HCC and non-HCC groups had similar cumulative rates of HBV-DNA
negativity, ALT normalization, and hepatitis e antigen loss in year 2 (100%
vs. 95.4%, 94.7% vs. 97.3%, and 40.8% vs. 41.8%, respectively; P > 0.05).
Entecavir treatment for 12 months decreased mean Model for End-Stage Liver
Disease scores in patients with cirrhosis and HCC (7.2 vs. 5.6, P < 0.001).
Of the 71 HCC patients, 16 underwent curative therapies concurrently with
entecavir; hepatectomy in six and radiofrequency ablation in ten, and the
55 remaining patients received transarterial chemoembolization or
conservative treatment. In a subgroup of 16 HCC patients receiving curative
treatments, patients who became serum HBV DNA negative by week 24 had
better overall survival (P= 0.039), but not recurrence-free survival (P=
0.961), than those who did not.
Conclusions: First-line entecavir monotherapy is comparably effective in
CHB patients with and without HCC, and improves hepatic function in
HBV-related HCC patients. An early virological response to entecavir is
prognostic of improved survival following curative therapy against
HBV-related HCC.