我们可以从乙肝病毒的临床各县学到了什么？

StephenW

Liver Int. 2015 Jan;35 Suppl 1:91-9. doi: 10.1111/liv.12716.
What can we learn from hepatitis B virus clinical cohorts?
Lin CL1, Tseng TC, Kao JH.
Author information

    1Department of Gastroenterology, Ren-Ai branch, Taipei City Hospital, Taipei, Taiwan; Department of Psychology, National Chengchi University, Taipei, Taiwan.

Abstract

Chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC) are considered to be sequential adverse outcomes in patients with persistent hepatitis B virus (HBV) infection. HBV infection is endemic in Taiwan and most HBV carriers acquire the virus early in life. The impact of HBV factors on the natural course of patients with chronic HBV infection has been investigated in three cohort studies. The first Risk Evaluation of Viral Load Elevation and Associated Liver Disease/Cancer-Hepatitis B Virus (REVEAL-HBV) cohort study revealed that HBV viral load is a strong predictive factor for the risk of cirrhosis and HCC and baseline serum HBV DNA levels >2000 IU/ml may increase the risk of cirrhosis and HCC in adult HBV carriers. In the second Study of E Antigen seRoClearance of Hepatitis B (SEARCH-B), HBsAg level <100 IU/ml at 1-year post HBeAg seroconversion was shown to be a predictor of HBsAg seroclearance over time. Recently, the third Elucidation of Risk Factors for Disease Control or Advancement in Taiwanese Hepatitis B Carriers (ERADICATE-B) cohort study also suggested that HBsAg levels were a complementary predictive risk factor to HBV DNA levels for predicting HBV-related adverse events in patients with low viral load (HBV DNA level <2000 IU/ml). An HBsAg level >1000 IU/ml in HBeAg-negative patients with low viral load, is associated with higher risks of HCC, cirrhosis, and HBeAg-negative hepatitis. Based on results of the REVEAL-HBV cohort study, a risk calculator to predict HCC in non-cirrhotic patients was developed and validated by independent international cohorts (REACH-B). In the recent update of the REVEAL-HBV study, HBsAg level was incorporated into the HCC risk prediction model with excellent accuracy. In conclusion, evidence from these HBV clinical cohorts confirms the progression and integration of viral biomarkers for the prediction of the prognosis of Asian chronic hepatitis B (CHB) patients. If the predictive power of the HCC risk calculator could be validated in non-Asian populations, it could be used in clinical practice to individualize the management of HBV carriers with different levels of HCC risk.

© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
KEYWORDS:

HBV DNA; HBsAg; chronic hepatitis B; hepatocellular carcinoma; risk calculator

StephenW

肝诠释。 2015年1月35增刊1：91-9。 DOI：10.1111/ liv.12716。
我们可以从乙肝病毒的临床各县学到了什么？
CL1林曾TC花王JH。
作者信息

    消化内科教研室，任艾枝，台北市医院，台北，台湾;心理学的国立政治大学系，台湾台北。

抽象

慢性肝炎，肝硬化和肝细胞癌（HCC）被认为是在患者持续乙型肝炎病毒（HBV）感染的顺序不良结果。 HBV感染的流行在台湾和MOST乙肝病毒携带者在生命早期获得病毒。 HBV保对慢性HBV感染的自然病程的影响是，被调查三个队列研究。对病毒载量高程及相关肝病/癌症，乙型肝炎病毒（REVEAL-HBV）的第一个风险评估队列研究HBV病毒载量发现，是一个强有力的预测因素肝硬化和HCC和基线血清HBV DNA水平>2000的风险IU/ ml的可能增加肝硬化和肝癌的乙肝病毒携带者成人的风险。在B型肝炎（SEARCH-B）中的HBsAg水平的抗原Ë血清清除的第二研究<100国际单位/毫升，在1年后的血清转换被证明是HBsAg的血清清除的随时间的预测。近日，危险因素的疾病控制的黄金进步的台湾乙肝携带者（消除-B）队列研究澳大利亚游泳会第三阐明suggéré这HBsAg水平是预测风险因素相辅相成HBV DNA水平预测HBV相关的不良事件的患者低病毒载量（HBV DNA水平<2000 IU/毫升）。一个乙肝表面抗原水平>1000 IU/ mL的HBeAg阴性患者的病毒载量低，与肝癌，肝硬化和HBeAg阴性乙肝的风险较高的相关性。基于对REVEAL-HBV队列研究的结果，风险计算器肝硬化患者非开发和独立的国际各县（REACH-B）验证预测HCC。在最近的REVEAL-HBV研究更新，乙肝表面抗原水平被纳入具有优良的精度肝癌的风险预测模型。总之，从临床HBV论文各县证据证实的增长和一体化病毒标志物治疗慢性乙型肝炎的亚洲（CHB）患者的预后预测。如果HCC风险计算器的预测能力能否在非亚洲人群进行验证，这可能是在临床实践中，以个性化乙肝病毒携带者的管理，不同级别的HCC危险。

©2014年约翰·威利父子A / S。发布时间由John Wiley＆Sons出版有限公司
关键词：

HBV DNA;乙肝表面抗原;慢性乙型肝炎;肝癌;风险计算器

bigben446

clinical cohorts----临床群组差不多的意思吧