目前正在用核苷酸（t）ide类似物治疗的慢性乙型肝炎患者的

StephenW

Monitoring and comorbidities in patients with chronic hepatitis B currently treated with nucleos(t)ide analogs
Spyros Siakavellas  1 , John Goulis  2 , Spilios Manolakopoulos  1   3 , Christos Triantos  4 , Nikolaos Gatselis  5 , Eva Tsentemidou  2 , Hariklia Kranidioti  3 , Κonstantinos Ζisimopoulos  4 , Christos Τsoulas  6 , George Dalekos  5 , George Papatheodoridis  1
Affiliations
Affiliations

    1
    Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, "Laiko" General Hospital of Athens, Athens (Spyros Siakavellas, Spilios Manolakopoulos, George Papatheodoridis).
    2
    4 Department of Internal Medicine, Medical School of Aristotle University of Thessaloniki (John Goulis, Eva Tsentemidou).
    3
    2 Department of Internal Medicine, Medical School of National and Kapodistrian University of Athens, Hippokratio General Hospital, Athens (Spilios Manolakopoulos, Hariklia Kranidioti).
    4
    Division of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, Rio (Christos Triantos, Konstantinos Zisimopoulos).
    5
    Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa (Nikolaos Gatselis, George Dalekos).
    6
    Medical Department, Gilead Sciences Hellas (Christos Tsoulas), Greece.

    PMID: 33414625 PMCID: PMC7774663 DOI: 10.20524/aog.2020.0525

Free PMC article
Abstract

Background: Long-term monotherapy with nucleos(t)ide analogs (NAs) represents the treatment option for the majority of patients with chronic hepatitis B (CHB), an aging population with a greater likelihood of comorbidities. We assessed the prevalence of concurrent non-hepatic diseases and the safety monitoring in a large cohort of CHB patients receiving NAs and their potential impact on disease outcomes.

Methods: We included 500 consecutive CHB patients from 5 major tertiary Greek centers, under long-term therapy with an NA. Epidemiological/clinical characteristics and data on concomitant disease, drug use and investigations ordered were collected.

Results: The mean age was 58 years and 66% were male. Most patients were receiving tenofovir disoproxil fumarate (TDF, 60%) or entecavir (ETV, 37%) monotherapy. Decompensated cirrhosis at baseline was present in 10%, while hepatocellular carcinoma (HCC) under therapy developed in 21 patients. The median duration of total NA therapy was 56 and of latest therapy 42 months. The most common (prevalence >10%) comorbidities were hypertension (28%), non-HCC cancer(s) (12%), and diabetes (11%). Patients with a longer duration of latest therapy (≥4 vs. <4 years) were older (mean age: 58 vs. 56 years, P=0.004), had more frequent history of prior use of NA(s) (53% vs. 35%, P<0.001), and less frequent liver decompensation (5% vs. 13%, P=0.008) and non-HCC cancers (8% vs. 15%, P=0.020). HCC developed more frequently in patients with than in those without diabetes (11% vs. 3%, P=0.022).

Conclusion: Greek CHB patients currently treated with NAs, almost exclusively ETV or TDF, are often older than 60 years, have several comorbidities, and thus require careful management.

Keywords: Chronic hepatitis B; comorbidities; monitoring; nucleos(t)ide analog.

Copyright: © 2021 Hellenic Society of Gastroenterology.

StephenW

目前正在用核苷酸（t）ide类似物治疗的慢性乙型肝炎患者的监测和合并症
Spyros Siakavellas 1，John Goulis 2，Spilios Manolakopoulos 1 3，Christos Triantos 4，Nikolaos Gatselis 5，Eva Tsentemidou 2，Hariklia Kranidioti 3，KKonstantinos Znisimopoulos 4，ChristosΤsoulas6，George Dalekos 5，George Papatheodor 1
隶属关系
隶属关系

    1个
    国立雅典大学和卡波迪斯安大学医学院胃肠病学系，雅典“莱科”总医院，雅典（Spyros Siakavellas，Splioos Manolakopoulos，George Papatheodoridis）。
    2
    4塞萨洛尼基亚里士多德大学医学院内科系（约翰·古利斯，伊娃·森特米杜）。
    3
    2雅典国立卡普迪斯安大学医学院内科，雅典希波克拉比综合医院（Spilios Manolakopoulos，Hariklia Kranidioti）。
    4
    里约热内卢帕特雷大学医院内科消化内科（Christos Triantos，Konstantinos Zisimopoulos）。
    5
    拉里萨综合大学医院（Nikolaos Gatselis，George Dalekos），希腊国家自身免疫性肝病国家专家中心内科医学研究室和内科学研究实验室。
    6
    希腊吉列德科学·海拉斯（Christos Tsoulas）医务部。

    PMID：33414625 PMCID：PMC7774663 DOI：10.20524 / aog.2020.0525

免费PMC文章
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背景：长期使用核苷酸类似物（NAs）进行单一疗法是大多数慢性乙型肝炎（CHB）患者的治疗选择，慢性乙型肝炎是一个人口老龄化，合并症的可能性更大。我们评估了一大批接受NA的CHB患者并发非肝疾病的患病率和安全性监测及其对疾病结局的潜在影响。

方法：我们纳入了来自希腊5个主要三级中心的500名连续CHB患者，接受了NA的长期治疗。收集了流行病学/临床特征以及有关伴随疾病，药物使用和所定调查的数据。

结果：平均年龄为58岁，其中66％为男性。大多数患者接受单药联合富马酸替诺福韦酯（TDF，60％）或恩替卡韦（ETV，37％）。基线时发生代偿性肝硬化的比例为10％，而接受治疗的肝细胞癌（HCC）则为21例。总NA治疗的中位持续时间为56个月，最新治疗为42个月。最常见的合并症（患病率> 10％）是高血压（28％），非HCC癌症（12％）和糖尿病（11％）。最近治疗时间较长（≥4vs. <4岁）的患者年龄较大（平均年龄：58 vs. 56岁，P = 0.004），以前使用NA的频率更高（53％vs 35％，P <0.001），较少发生肝代偿失调（5％vs. 13％，P = 0.008）和非HCC癌症（8％vs. 15％，P = 0.020）。与没有糖尿病的患者相比，肝癌的发生率更高（11％vs. 3％，P = 0.022）。

结论：目前接受NAs治疗的希腊CHB患者（几乎仅接受ETV或TDF治疗）通常年龄超过60岁，患有多种合并症，因此需要仔细治疗。

关键字：慢性乙型肝炎；合并症监控；核苷类似物。

版权：©2021希腊胃肠病学会。

StephenW

http://www.annalsgastro.gr/files ... 25-AG_5290-0525.pdf