恩替卡韦治疗HBeAg阴性慢性乙型肝炎患者的代偿性肝硬化中断

StephenW

Aliment Pharmacol Ther. 2015 Sep 18. doi: 10.1111/apt.13409. [Epub ahead of print]
Clinical outcomes after interruption of entecavir therapy in HBeAg-negative chronic hepatitis B patients with compensated cirrhosis.Chen YC1, Peng CY2, Jeng WJ1, Chien RN3, Liaw YF1.
Author information

• 1Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan.
• 2School of Medicine, Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
• 3Liver Research Unit, Chang Gung Memorial Hospital and University, Keelung, Taiwan.
  

AbstractBACKGROUND: Long-term nucleos(t)ide analogues therapy may reduce hepatocellular carcinoma (HCC) in chronic hepatitis B patients with advanced fibrosis or cirrhosis.
AIM: To investigate in a retrospective-prospective study whether this beneficial effect would be reduced in cirrhotic patients who discontinued a successful course of entecavir (ETV) therapy.
METHODS: The study included 586 hepatitis B e antigen (HBeAg)-negative patients with compensated cirrhosis, mean age of 53.8 ± 10 years and 81% males, treated with ETV for at least 12 months. After ETV therapy for 46.5 ± 22.9 months, 205 patients who achieved hepatitis B virus (HBV) DNA suppression discontinued therapy. The clinical outcomes were assessed and HCC incidence was compared between propensity score (PS)-matched patients who continued and patients who discontinued ETV therapy by Asian Pacific Association for the Study of Liver stopping rule.
RESULTS: During a mean duration of 59.3 ± 19 months after start of ETV therapy, nine and six HCC developed in an estimated annual incidence of 2.3% and 1.6% in 154 PS-matched patients who continued and who discontinued ETV therapy, respectively (P = 0.587). Multivariate Cox proportional hazards regression analyses showed that age (HR 1.065, P < 0.001) and HBV DNA (HR 1.216, P = 0.048) were the significant factors for HCC development. The rates of adverse clinical outcomes were comparable.
CONCLUSIONS: The clinical outcomes, including HCC, after cessation of a successful course of entecavir therapy in patients with compensated cirrhosis were comparable to those who continued therapy. The results suggest that this strategy of finite therapy is safe and a feasible alternative to indefinite therapy, especially in a low resources setting.
© 2015 John Wiley & Sons Ltd.

StephenW

ALIMENT药理疗法。 2015年九月18 DOI：10.1111 / apt.13409。 [打印EPUB提前]
恩替卡韦治疗HBeAg阴性慢性乙型肝炎患者的代偿性肝硬化中断后的临床结果。
陈YC1，彭CY2，钲WJ1，简RN3，廖YF1。
作者信息

    1Liver研究单位，长庚医院，医学院，台北，台湾长庚大学。
    2School医学，Hepatogastroenterology，内科，中国医学大学附设医院，台中，台湾的事业部。
    3Liver研究单位，长庚医院和大学，台湾基隆。

抽象的
背景：

长期的核苷（酸）类似物治疗可降低慢性乙型肝炎患者的肝纤维化或肝硬化肝细胞癌（HCC）。
目的：

要在回顾性，前瞻性研究探讨这一有益的效果是否会减少在谁停止恩替卡韦（ETV）治疗的成功当然肝硬化患者。
方法：

该研究共纳入586乙型肝炎e抗原（HBeAg）阴性患者的代偿性肝硬化，平均53.8±10岁，81％为男性，恩替卡韦治疗至少12个月的年龄。后ETV疗法46.5±22.9个月的，谁取得乙型肝炎病毒（HBV）DNA抑制中止治疗205例。临床结果进行了评估和HCC发生率谁继续倾向得分（PS）项匹配的病人和谁停止ETV治疗由亚太协会肝脏停止规则的研究患者进行了比较。
结果：

在59.3±19个月ETV治疗，九和六肝癌的2.3％和154 PS匹配的患者的1.6％，估计每年发病开发开始后，平均持续时间谁继续和谁停止ETV治疗，分别为（P = 0.587 ）。多因素Cox比例风险回归分析显示，年龄（HR 1.065，P <0.001）和HBV-DNA（HR 1.216，P = 0.048）是显著因素，肝癌的发展。的不良临床结局发生率是相当的。
结论：

临床结果，包括肝癌，恩替卡韦停止治疗的患者的代偿性肝硬化成功当然后是可比那些谁的持续治疗。结果表明，有限的治疗这种策略是安全的，一个可行的替代无限期疗法，特别是在低的资源设置。

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