比较未经治疗的免疫耐受期的慢性乙型肝炎患者与抗病毒药

StephenW

Sci Rep. 2019 Feb 21;9(1):2508. doi: 10.1038/s41598-019-39043-2.
Comparison between chronic hepatitis B patients with untreated immune-tolerant phase vs. those with virological response by antivirals.
Lee HW1,2,3, Kim SU1,2,3, Oidov B1,4, Park JY1,2,3, Kim DY1,2,3, Ahn SH1,2,3, Han KH1,2,3, Kim BK5,6,7.
Author information

1
    Department of Internal medicine, Yonsei University College of medicine, Seoul, Republic of Korea.
2
    Institute of Gastroenterology, Yonsei University College of medicine, Seoul, Republic of Korea.
3
    Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea.
4
    Department of Infectious Diseases, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
5
    Department of Internal medicine, Yonsei University College of medicine, Seoul, Republic of Korea. [email protected].
6
    Institute of Gastroenterology, Yonsei University College of medicine, Seoul, Republic of Korea. [email protected].
7
    Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea. [email protected].

Abstract

Routine nucleos(t)ide analogs (NUCs) have not yet been recommended for patients with immune-tolerant (IT) phase in chronic hepatitis B virus (HBV) infection. We aimed to evaluate prognosis of patients in untreated IT-phase (UIT group), compared to those in immune-active phase who achieved virological response by NUCs according to guidelines (VR group). Between 2006 and 2012, patients in UIT or VR groups were included. Cumulative risks of HCC and liver-related events (LREs) development were assessed. Furthermore, propensity-score was calculated based upon age, gender, diabetes and liver stiffness. UIT group (n = 126) showed younger age, lower proportion of male gender and lower LS than VR group (n = 641). UIT group had similar 10-year cumulative risks of HCC (2.7% vs. 2.9%, p = 0.704) and LRE (4.6% vs. 6.1%, p = 0.903) development, compared to VR group. When we re-defined UIT group by the lower ALT cut-offs, 10-year cumulative risks of HCC and LRE development were 2.9% and 4.8%, respectively. Using propensity-score matching and inverse probability treatment weighting analysis, similar results were reproduced. UIT group consistently had similar prognosis compared to VR group. Therefore, further large-scale prospective studies in order to verify rationales of routine NUCs in UIT group are still required.

PMID:
    30792468
DOI:
    10.1038/s41598-019-39043-2

StephenW

Sci Rep.20119 Feb 21; 9（1）：2508。 doi：10.1038 / s41598-019-39043-2。
比较未经治疗的免疫耐受期的慢性乙型肝炎患者与抗病毒药物的病毒学应答。
Lee HW1,2,3，Kim SU1,2,3，Oidov B1,4，Park JY1,2,3，Kim DY1,2,3，Ahn SH1,2,3，Han KH1,2,3，Kim BK5， 6,7。
作者信息

1
    延世大学医学院内科，韩国首尔。
2
    延世大学医学院消化内科，韩国首尔。
3
    韩国首尔Severance医院延世肝脏中心。
4
    蒙古国立医科大学传染病系，蒙古乌兰巴托。
五
    延世大学医学院内科，韩国首尔。 [email protected]。
6
    延世大学医学院消化内科，韩国首尔。 [email protected]。
7
    韩国首尔Severance医院延世肝脏中心。 [email protected]。

抽象

对于慢性乙型肝炎病毒（HBV）感染的免疫耐受（IT）阶段的患者，尚未推荐常规核苷（t）ide类似物（NUC）。我们的目的是评估未治疗IT阶段（UIT组）患者的预后，与根据指南（VR组）通过NUC实现病毒学应答的免疫活性期患者相比。在2006年至2012年期间，包括UIT或VR组的患者。评估了HCC和肝脏相关事件（LRE）发展的累积风险。此外，根据年龄，性别，糖尿病和肝硬度计算倾向评分。 UIT组（n = 126）显示年龄较小，男性性别比例较低，LS低于VR组（n = 641）。与VR组相比，UIT组的HCC累积风险与HCC相似，分别为2.7％（2.7％vs。2.9％，p = 0.704）和LRE（4.6％vs。6.1％，p = 0.903）。当我们通过较低的ALT临界值重新定义UIT组时，HCC和LRE发展的10年累积风险分别为2.9％和4.8％。使用倾向得分匹配和逆概率处理加权分析，再现了类似的结果。与VR组相比，UIT组始终具有相似的预后。因此，仍需要进一步的大规模前瞻性研究，以验证UIT组常规NUC的基本原理。

结论：
    30792468
DOI：
    10.1038 / s41598-019-39043-2

neilhbver

这篇说耐受期预后跟吃药的类似，各个研究也不知道该听谁的f