SEROCLEARANCE OF HBV DNA IS THE MOST IMPORTANT PREDICTOR FOR THE REDUCED RISK HC

kennyu

http://www1.easl.eu/easl2011/program/Orals/332.htm

Background and aims: Chronic hepatitis B virus (HBV)infection is a serious public health problem because of its worldwideprevalence and potential to cause adverse consequences such as livercirrhosis and hepatocellular carcinoma (HCC). Serostatus of HBV surfaceantigen (HBsAg) and e antigen (HBeAg) and serum level of HBV DNA havebeen well documented as independent risk predictors of HCC. This studyaims to assess the importance of the seroclearance of HBV DNA, HBeAgand HBsAg in the prediction of subsequent reduction of HCC risk.
Methods: Basedon a prospective community-based cohort study, a total of 1285individuals with baseline serum HBV DNA levels ≥10,000 copies/mL wereenrolled in 1991-1992 and followed up until December 31st,2007. Serum samples collected at baseline and follow-up examinationswere tested for HBsAg, HBeAg, and serum HBV DNA level. Time-dependentCox proportional hazards models were used to estimatemultivariate-adjusted hazard ratios (HR) with 95% confidence intervals(CI) of developing HCC associated with HBsAg seroclearance, HBeAgseroclearance and HBV DNA seroclearance. The Kaplan-Meier method wasused to examine the cumulative probability of developing HCC associatedwith the seroclearance of various HBV infection markers.
Results: Among1285 participants included in this analysis, 111 newly diagnosed casesof HCC occurred during 19,321 person-years of follow-up. Seroclearanceof serum HBV DNA to undetectable levels was the most importantpredictor of the reduction of HCC risk, showing a multivariate-adjustedHR (95% CI) of 0.28 (0.08-0.98). There was no significant difference inHCC risk between participants with and without HBeAg seroclearance(multivariate-adjusted HR [95% CI] of 0.85 [0.53-1.36]), or betweenparticipants with and without HBsAg seroclearance(multivariate-adjusted HR [95% CI] of 0.73 [0.09-6.25]), afteradjustment for HBV DNA seroclearance. Among participants withseroclearance of HBV DNA, there was no difference in HCC risk betweenthose with and without HBsAg seroclearance, showing a cumulative HCCincidence of 1.6% and 1.9%, respectively (P=0.89).
Conclusions: Decreasingserum HBV DNA level to undetectable is the most important predictor ofreduced HCC risk. This finding has significant implications for theclinical treatment of chronic hepatitis B.

lin12345

背景和目的：慢性乙型肝炎病毒（HBV）感染是一个严重的，因为它worldwideprevalence和潜力，引起诸如livercirrhosis和肝细胞癌（HCC）的不良后果的公共健康问题。乙肝病毒表面抗原的（HBsAg）和e抗原（HBeAg）和血清中HBV DNA的一些疑问和水平血清状况有案可稽的肝细胞癌的独立危险因子。这studyaims评估肝癌风险的预测随后减少对乙肝病毒的DNA，乙肝表面抗原血清廓清HBeAgand的重要性。
方法：是依据未来社区为基础的队列研究中，与基线血清HBV DNA水平1285individuals总≥10000份/毫升wereenrolled在1991-1992年和随访至07年12月31日注册。血清样品收集基线和后续examinationswere为乙肝表面抗原，e抗原，血清HBV DNA水平测试。时间dependentCox比例风险模型被用来estimatemultivariate调整风险比率在95％置信区间（CI）发展中国家肝癌与HBsAg血清廓清，HBeAgseroclearance和HBV DNA血清廓清相关（小时）。以Kaplan - Meier法wasused，研究开发associatedwith各种乙肝病毒感染标志物血清廓清肝癌的累积概率。
结果：Among1285参与这项分析包括111初诊casesof肝癌发生在19321人年的后续行动。 Seroclearanceof血清HBV DNA检测不到的水平是肝癌的风险降低最importantpredictor，呈现出多元0.28 - adjustedHR（95％CI）的（0.08-0.98）。无显着差异inHCC与无HBeAg血清廓清（多变项调整后的人力资源[95％CI]为0.85 [0.53-1.36]），或与betweenparticipants参与者和乙肝表面抗原血清廓清无（多变项调整后的人力资源[95％CI]为风险0.73 [0.09-6.25]），对HBV DNA的血清廓清afteradjustment。参与者之间的HBV DNA withseroclearance，没有任何风险betweenthose肝癌与乙肝表面抗原血清廓清无，显示了1.6％和1.9％，（P均= 0.89）的累积HCCincidence差异。
结论：Decreasingserum HBV DNA水平检测不到，是最重要的预测ofreduced肝癌的风险。这一发现为治疗慢性乙型肝炎theclinical重大影响

StephenW

回复 kennyu 的帖子

Another Taiwan study. 0 hbvdna seems to be the key, again.

jjpest

     32岁，男，小三，dna10^4-10^5,肝功能正常，感染时间也就5年以内。以前医生的意思是3月至半年复查就可以，这么看我还是得加入抗病毒的队伍了啊。
    身体没有一点不舒服的感觉，打心里不想破坏现在的这个平衡。。。。。。但是最近的学界的说法对病毒载量越来越看重了，纠结啊。