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标题:
The Prognosis of Hepatitis B-related Liver Cirrhosis in the Era of Oral Nucleos(
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作者:
StephenW
时间:
2012-5-14 18:10
标题:
The Prognosis of Hepatitis B-related Liver Cirrhosis in the Era of Oral Nucleos(
本帖最后由 StephenW 于 2012-5-14 18:11 编辑
J Gastroenterol Hepatol.
2012 May 3. doi: 10.1111/j.1440-1746.2012.07167.x. [Epub ahead of print]
The Prognosis of Hepatitis B-related Liver Cirrhosis in the Era of Oral Nucleos(t)ide analogue Antiviral Agents.
Kim CH
,
Um SH
,
Seo YS
,
Jung JY
,
Kim JD
,
Yim HJ
,
Keum B
,
Kim YS
,
Jeen YT
,
Lee HS
,
Chun HJ
,
Kim CD
,
Ryu HS
.
SourceDepartment of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Abstract
Background & Aims: We investigated long-term outcomes and prognostic factors in patients with hepatitis B virus (HBV)-related liver cirrhosis in the era of oral nucleos(t)ide analogue antiviral agents. Methods: Between January 1999 and February 2009, a total of 240 consecutive patients who had HBV-related cirrhosis without malignancy were treated with lamivudine and second line nucleos(t)ide analogues. The group of historical controls consisted of 481 consecutive patients with HBV-related cirrhosis who were managed without any antiviral treatment prior to 1999. Results: In 78% of the patients who received antiviral treatment, sustained viral suppression (serum HBV DNA <10(5 ) copies/mL) was achieved during a mean follow-up period of 46 months. The occurrences of death, hepatic decompensation, and hepatocellular carcinoma (HCC) were less frequent in the treated cohort than in untreated historical controls, with the 5-year cumulative incidences being 19.4% vs. 43.9% (log-rank p<0.001), 15.4% vs. 45.4% (p=0.001), and 13.8% vs. 23.4% (p=0.074), respectively. For patients who received antiviral treatment, suboptimal viral suppression (HBV DNA >10(5 ) copies/mL at last follow-up) was an important independent risk factor of death (p<0.001) and hepatic decompensation (p=0.019), and was linked to an increased risk of HCC (p=0.042). Although the Child-Pugh grade remained a useful prognostic factor, no significant differences were found between patients with Child-Pugh grade B and C cirrhosis at the beginning of antiviral treatment (p=0.656).
Conclusions: Oral antiviral agents have improved the prognosis of patients with HBV-related cirrhosis and affected the prognostic values of factors constituting the Child-Pugh system, necessitating a more efficient prognostic system. © 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
作者:
StephenW
时间:
2012-5-14 18:10
胃肠肝胆病杂志。 2012五月3。 DOI:10.1111/j.1440-1746.2012.07167.x。 [出处提前打印]
B型肝炎相关的肝硬化患者口服核苷(酸)类似物IDE抗病毒药时代的预后。
金通道,庵的SH,徐黏,郑精云,金JD,盐田黄建忠,Keum乙,金黏,Jeen玉堂,李协,春黄建忠,金CD,刘某HS。
源
内科,韩国,韩国汉城大学医学院。
抽象
背景与目的:我们调查长期结果和预后因素的患者与乙型肝炎病毒(HBV)相关肝硬化的口服核苷(酸)IDE类似物抗病毒药物的时代。方法:1999年1月至2009年2月共240例,无恶性HBV相关性肝硬化的治疗与拉米夫定和第二行的核苷(酸)IDE类似物。历史对照组连续的481人在1999年以前没有任何抗病毒治疗管理与HBV相关性肝硬化患者。结果:在接受抗病毒药物治疗的患者的78%,持续的病毒抑制(血清HBV DNA <10(5)拷贝/毫升)在平均随访46个月内实现。死亡,肝功能失代偿,肝细胞癌(HCC)的发生,在处理队列频繁,比未经处理的历史对照,5年累计发生率19.4%与43.9%(对数秩P <0.001), 15.4%和45.4%(P = 0.001),13.8%和23.4%(P = 0.074),分别。为病人接受抗病毒药物治疗,最理想的病毒抑制(血清HBV DNA> 10(5)拷贝/ mL,最后跟进)是死亡的一个重要的独立危险因素(P <0.001)和肝功能失代偿(P = 0.019),与肝癌(P = 0.042)的风险增加。虽然儿童Pugh分级仍然是一个有用的预后因素,发现与Child-Pugh分级B级和C肝硬化患者在开始抗病毒治疗(P = 0.656)之间无显着性差异。结论:口服抗病毒药物的改善与HBV相关性肝硬化患者的预后及影响因素,构成Child-Pugh分级系统的预测值,需要一个更有效的预测系统。 ©2012 - 胃肠病学和肝病基金会和Blackwell出版亚洲私人有限公司
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