AASLD2014:恩替卡韦改善肝功能和肝纤维化患者乙型肝炎病毒相

StephenW

1877
Entecavir Improves Liver Function and Fibrosis in Patients with Hepatitis B Virus-associated Liver Cirrhosis: A 2 Years-Multicenter Study
Seung Kak Shin1, Oh Sang Kwon1, Jong Eun Yeon2, Jeong Han Kim3, So Young Kwon3, Sang Jun Suh4, Yun Soo Kim1, Ju Hyun Kim1;
1Internal Medicine, Gachon University Gil Medical Center, Inchon, Republic of Korea; 2Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea; 3Internal Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea; 4Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea

Background and aims: Entecavir (ETV) induces biochemical and histologic improvement of the liver in patients with chronic hepatitis B. This study aimed to verify whether ETV improves liver function and fibrosis in patients with hepatitis B virus (HBV)-associated liver cirrhosis (LC) during 2 years treatment.
Methods: A total 430 naTve patients with HBV associated LC was treated by ETV for at least 2 years, between March 2007 and December 2012. Exclusion criteria were the patients who 1) skipped the ETV more than 3 months and 2) had the development of hepatocelullar carcinoma within 2 years after ETV treatment. For the evaluation of liver function, laboratory findings, model for end stage liver disease (MELD) score, and Child-Pugh (CP) class were compared between the baseline and 2 years after ETV treatment. For the evaluation of fibrosis, AST platelet ratio index (APRI) score, FIB-4 index, and fibrosis index (FI) were compared between the baseline and 2 years after ETV treatment.
Results: The final 370 patients were enrolled. The mean age was 51 ±10 years and 64.9% of patients was male. The baseline mean AST and ALT were 126±150 IU/L and 128±169 IU/L, respectively. The mean HBV DNA level was 7.0±1.2 log copies/mL. At 2 years after ETV treatment, the rate of ALT normalization was 80.5%, HBeAg loss in HBeAg positive-patients (n=182) was 37.0% and the undetectable rate of HBV DNA (by real-time polymerase chain reaction, detection limit: >120 copies/mL) was 88.3%. The changes of total bilirubin, albumin, platelet count, and MELD score between the two time points were from 1.9±2.6 to 1.3±1.0 mg/dL (p<0.001), from 3.7±0.6 to 4.1 ±0.5 g/dL (p<0.001), from 102±40 to 106±44 x1000/mm3 (p<0.001), and from 8.5±4.6 to 6.2±4.2 (p<0.001), respectively. The distribution of CP class at baseline was 71.1% in A, 24.6% i n B, and 4.3% in C. The distribution of CP class at 2 year after ETV treatment was 89.5% in A, 9.7% in B, and 0.8% in C. The change of CP class between the two time points was significant (p<0.001). The changes of APRI score, FIB-4 index, and FI between the two time points were from 3.6±4.5 to 1.5±1.5 (p<0.001), from 7.0±6.2 to 3.9±2.8 (p<0.001), and from 3.3±0.9 to 2.5±1.1 (p<0.001), respectively.
Conclusions: Entecavir improves not only liver function but also fibrosis in patients with HBV-associ-ated LC for long-term treatment.

Disclosures:

The following people have nothing to disclose: Seung Kak Shin, Oh Sang Kwon, Jong Eun Yeon, Jeong Han Kim, So Young Kwon, Sang Jun Suh, Yun Soo Kim, Ju Hyun Kim

StephenW

1877
恩替卡韦改善肝功能和肝纤维化患者乙型肝炎病毒相关性肝硬化：有2年，多中心研究
承珏Shin1，吴尚Kwon1，金正恩Yeon2，郑韩Kim3，这么年轻Kwon3，桑俊Suh4，润洙Kim1，李惠英Kim1;
1Internal医药，嘉泉大学吉尔医学中心，仁川，韩国; 2Internal医药，高丽大学九老医院，首尔，韩国; 3Internal医药，建国大学医学院，韩国汉城的; 4Internal医药，高丽大学安山医院，安山，大韩民国

背景和目的：恩替卡韦（ETV）诱导的肝脏慢性乙型肝炎本研究旨在验证恩替卡韦是否能改善患者的乙肝病毒（HBV）相关性肝硬化肝功能和肝纤维化生化和组织学改善（LC ）在治疗2年。
方法：430 naTve例HBV相关的立法是由恩替卡韦治疗至少2年，2007年3月至十二月期间2012年排除标准是谁1）跳过教育电视超过3个月和2）有发展的患者在ETV治疗2年后hepatocelullar癌。对于肝功能，化验结果显示，型号为终末期肝病（MELD）评分，Child-Pugh分级（CP）班的评价基准和恩替卡韦治疗2年后进行比较。纤维化的评价中，AST血小板比值指数（APRI）得分，FIB-4指数，和纤维化指数（FI）在基线和ETV治疗2年后进行比较。
结果：最终的370名患者参加。平均年龄为51±10岁的患者64.9％为男性。基线平均AST和ALT分别为126±150 IU / L和128±169 IU / L，分别。平均血清HBV DNA水平为7.0±1.2日志拷贝/毫升。在ETV治疗2年后，ALT复常率为80.5％，HBeAg阴转HBeAg阳性，患者（n=182）为37.0％和HBV DNA的检测不到率（通过实时聚合酶链反应，检测限： > 120拷贝/ ml）为88.3％。总胆红素，白蛋白，血小板计数的变化，MELD两个时间点之间的得分分别为1.9±2.6至1.3±1.0毫克/分升（P <0.001），从3.7±0.6至4.1±0.5克/分升（P <0.001），从102±40至106±44×1000个/ mm3（P <0.001），从8.5±4.6至6.2±4.2（P <0.001）。 CP级的基线分布在71.1％，B中24.6％，而在C4.3％蛋白类的2年恩替卡韦治疗后的分配是在一个89.5％，B中为9.7％，和0.8％ C.两个时间点之间的CP级的变化是显著（P <0.001）。 APRI得分，FIB-4指数，并在两个时间点之间的FI的变化是由3.6±4.5到1.5±1.5（P <0.001），从7.0±6.2到3.9±2.8（P <0.001），和从3.3 ±0.9到2.5±1.1（P <0.001），分别。
结论：恩替卡韦不仅提高肝功能，而且还纤维化患者的HBV-associ-ATED LC长期治疗。

披露：

下面的人都没有透露：升珏新，吴尚权，金正恩妍，郑韩金，这么年轻权，桑俊徐润秀金，李惠英金