年龄和纤维化指数可预测高乙型肝炎病毒DNA但丙氨酸转氨酶

StephenW

Age and fibrosis index for the prediction of hepatocellular carcinoma risk in patients with high hepatitis B virus DNA but normal alanine aminotransferase
Gyeol Seong, Dong Hyun Sinn, Wonseok Kang, Geum-Youn Gwak, Moon Seok Choi, Joon Hyeok Lee, Kwang Cheol Koh, Seung Woon Paik, Yong-Han Paik

    PMID: 32925504 DOI: 10.1097/MEG.0000000000001915

Abstract

Aim: Chronic hepatitis B patients positive for hepatitis B e antigen (HBeAg) with high serum hepatitis B virus (HBV) DNA levels but normal alanine aminotransferase (ALT) levels may develop hepatocellular carcinoma (HCC). However, ways to risk stratify are limited.

Methods: A retrospective cohort of 651 HBeAg positive, adult patients with high serum HBV DNA levels (>7 log IU/ml) but normal or mildly elevated ALT levels (<80 U/L) were analyzed.

Results: Age and FIB-4 index were independent factors associated with HCC development. When stratified, 5- and 10-year cumulative HCC incidence rates were 0 and 2.0% for patients aged <40 years with FIB-4 index <1.45, and were 5.9 and 32.7% for patients aged ≥40 years with FIB-4 index ≥1.45, respectively (P < 0.001). In patients with normal ALT levels (n = 301), the 10-year HCC incidence rate was 0% for patients aged <40 years with FIB-4 index <1.45, while 5- and 10-years HCC incidence rate was 4.5 and 27.1% for patients aged ≥40 years with FIB-4 index ≥1.45, respectively (P < 0.001).

Conclusion: In patients with high HBV DNA but normal ALT levels, age and FIB-4 index could effectively stratify HCC risk, indicating that these parameters may guide management plans for this population.

StephenW

年龄和纤维化指数可预测高乙型肝炎病毒DNA但丙氨酸转氨酶正常的肝癌风险
姜承,、董H新，姜元锡，郭锦You，文硕彩，俊赫利，光哲Koh，承焕Pa，白Yong汉

    PMID：32925504 DOI：10.1097 / MEG.0000000000001915

抽象

目的：慢性乙型肝炎患者的乙型肝炎e抗原（HBeAg）阳性，血清乙型肝炎病毒（HBV）DNA水平高，但丙氨酸氨基转移酶（ALT）正常，可能会发展为肝细胞癌（HCC）。但是，风险分层的方法是有限的。

方法：回顾性分析了651名HBeAg阳性，成年患者，其血清HBV DNA水平高（> 7 log IU / ml），但ALT水平正常或轻​​度升高（<80 U / L）。

结果：年龄和FIB-4指数是与肝癌发生相关的独立因素。分层后，<40岁的FIB-4指数<1.45的患者的5年和10年累积HCC发生率分别为0和2.0％，≥40岁的FIB-4指数≥的患者分别为5.9和32.7％。分别为1.45（P <0.001）。在ALT水平正常的患者中（n = 301），年龄小于40岁且FIB-4指数<1.45的患者的10年HCC发生率为0％，而5年和10年的HCC发生率分别为4.5和27.1分别≥40岁且FIB-4指数≥1.45的患者所占的百分比（P <0.001）。

结论：在HBV DNA高但ALT水平正常的患者中，年龄和FIB-4指数可以有效地将HCC风险分层，表明这些参数可以指导该人群的治疗计划。