Nucleos(t)ide Analogue Treatment for Patients With Hepatitis B Virus (HBV) e Antigen–Positive Chronic HBV Genotype C Infection: A Nationwide, Multicenter, Retrospective Study
Young Chang Won Hyeok Choe Dong Hyun Sinn Jeong-Hoon Lee Sang Hoon Ahn Hyewon Lee Jae-Jun Shim Dae Won Jun Soo Young Park Joon Yeul Nam ... Show more
The Journal of Infectious Diseases, Volume 216, Issue 11, 12 December 2017, Pages 1407–1414, https://doi.org/10.1093/infdis/jix506
Published:
23 September 2017
Abstract
Background
Antiviral treatment for hepatitis B virus (HBV) e antigen (HBeAg)–positive chronic HBV infection is still controversial. We assessed whether antiviral treatment reduces the risk of liver disease progression in these patients.
Methods
This study included consecutive patients in 8 large-volume hospitals in Korea who tested positive for HBeAg and had an HBV DNA level of >20000 IU/mL, an alanine aminotransferase (ALT) level of <40 IU/L, and no evidence of cirrhosis. The primary end point was the development of hepatocellular carcinoma (HCC), and the secondary end point was the development of cirrhosis.
Results
A total of 484 patients were included: 87 were in the antiviral treatment group, and 397 were in the control group. Baseline liver function was significantly more favorable for the control group. After matching for propensity score to overcome those differences, the antiviral treatment group had a significantly reduced risk for HCC (hazard ratio [HR], 0.234; log-rank P = .046) and cirrhosis (HR, 0.235; log-rank P = .015), compared with the control group. After balancing the baseline characteristics by using inverse probability weighting, antiviral therapy significantly decreased the risk of HCC (HR, 0.189; log-rank P = .004) and cirrhosis (HR, 0.347; log-rank P = .036).
Conclusion
本研究纳入了韩国8家大型医院的连续患者，其检测HBeAg阳性，HBV DNA水平> 20000 IU / mL，丙氨酸转氨酶（ALT）水平<40 IU / L，无肝硬化。主要终点是肝细胞癌（HCC）的发展，次要终点是肝硬化的发展。
结果
共纳入484例患者：抗病毒治疗组87例，对照组397例。基线肝功能显着更有利于对照组。在匹配倾向评分以克服这些差异后，抗病毒治疗组HCC风险显着降低（风险比[HR]，0.234; log-rank P = .046）和肝硬化（HR，0.235; log-rank P = .015）与对照组比较。通过使用逆概率加权平衡基线特征后，抗病毒治疗显着降低HCC风险（HR，0.189; log-rank P = .004）和肝硬化（HR，0.347; log-rank P = .036）。
结论