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标题: 聚乙二醇干扰素优越于慢性乙肝核苷（酸）类似物对肝癌防 [打印本页]

作者: StephenW 时间: 2016-2-20 11:46 标题: 聚乙二醇干扰素优越于慢性乙肝核苷（酸）类似物对肝癌防

Peginterferon Is Superior to Nucleos(t)ide Analogues for Prevention of Hepatocellular Carcinoma in Chronic Hepatitis B

1Liver Research Center, Chang Gung Memorial Hospital
2Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan

Correspondence: C.-T. Yeh, Liver Research Center, Chang Gung Memorial Hospital, 199, Tung Hwa North Rd, Taipei, Taiwan (chautingy{at}gmail.com).

Presented in part: 50th International Liver Congress, Vienna, Austria, 22–26 April 2015. Abstract RS-1431.
↵a K.-H. L. and C.-W. H. contributed equally to the study.

Abstract

Background. Clinical factors associated with hepatocellular carcinoma (HCC) have been extensively studied in antiviral treatment–naive patients with chronic hepatitis B virus (HBV) infection but not in treatment-experienced patients. Owing to the wide availability of antiviral agents that effectively suppress HBV replication, we investigated HCC risk factors in treatment-experienced patients.

Methods. In a cohort of 330 patients who underwent pretherapeutic liver biopsy, we analyzed the HCC incidence in relationship to clinical parameters. Ultra-deep sequencing of the viral genome was performed on 11 entecavir-treated and pegylated interferon (peginterferon)–treated patients.

Results. Initial univariate/multivariate explorations indicated that cirrhosis and antiviral treatment were independently associated with HCC occurrence. The peginterferon-experienced patients had a lower HCC incidence than the nucleos(t)ide analogue–treated patients (P = .011). The peginterferon and entecavir monotherapy groups also differed in HCC incidence (P = .018). Results of analysis of baseline-matched subgroups concurred with cohort analysis (P = .009 for comparison of peginterferon-experienced vs nucleotide analogue–treated patients; P = .022 for comparison of peginterferon- vs entecavir-treated patients). Viral loads of entecavir-treated patients were constantly suppressed to levels lower than those of peginterferon-treated patients (P < .001). Oncogenic surface antigen truncation mutations were detected in entecavir-treated patients with HCC but not in peginterferon-treated patients (P = .015).

Conclusions. Treatment by peginterferon was associated with a lower HCC incidence than nucleos(t)ide-analogue treatment in chronic HBV infection.

Key words

作者: StephenW 时间: 2016-2-20 11:47

牛津期刊医药与健康的传染病杂志213卷第6期的PP。 966-974。
聚乙二醇干扰素优越于慢性乙型肝炎恭豪Liang1,2，一，超威Hsu1，一，明陵Chang1，易诚臣1，明伟Lai1和核苷（酸）类似物对肝癌防治洲亭Yeh1,2 1Liver研究中心，长庚医院2分子医学研究中心，长庚大学，桃园，台湾通讯：C.-T.叶，肝脏研究中心，长庚医院，199，通华北路，台北，台湾（chautingy {}在gmail.com）。呈现部分：第50届国际肝病会议上，奥地利维也纳，4月22-26日2015摘要RS-1431。 ↵aK.-H. L.和C.-W. H.同等贡献的研究。
抽象
背景。肝细胞癌（HCC）相关的临床因素已被广泛研究的抗病毒治疗的初治患者的慢性乙型肝炎病毒（HBV）感染，但没有治疗经验的患者。由于这有效抑制HBV复制抗病毒制剂的广泛应用，我们研究了治疗经验的患者肝癌的危险因素。
方法。在330名患者谁接受治疗前肝活检队列中，我们分析了关系临床参数肝癌发病率。于11恩替卡韦治疗和聚乙二醇干扰素（聚乙二醇干扰素）处理的患者进行的病毒基因组的超深度测序。
结果。初始单变量/多变量的探索表明，肝硬化，抗病毒治疗是独立与肝癌发生有关。聚乙二醇干扰素经验的患者有较低的肝癌发病率比核苷（酸）类似物IDE治疗的患者（P = 0.011）。聚乙二醇干扰素和恩替卡韦单药治疗组也有不同的发病率HCC（P = 0.018）。基线匹配的亚组分析的结果与队列分析同意（P = 0.009聚乙二醇干扰素经验丰富VS核苷类似物治疗的患者相比，P = 0.022为peg干扰素比较VS恩替卡韦治疗的患者）。恩替卡韦治疗的患者的病毒载量被不断抑制比聚乙二醇干扰素治疗的患者的较低水平（P <0.001）。在恩替卡韦治疗的患者肝癌检出致癌表面抗原突变截断，但不是在聚乙二醇干扰素治疗的患者（P = 0.015）。
结论。通过聚乙二醇干扰素治疗用较低的发病率HCC比慢性HBV感染核苷（酸）IDE-类似物治疗有关。
关键词队列分析预处理组织学HBV突变的超深度测序

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