聚乙二醇干扰素是优于慢性乙肝核苷（酸）类似物预防肝癌

StephenW

Peginterferon Is Superior to Nucleos(t)ide Analogues for Prevention of Hepatocellular Carcinoma in Chronic Hepatitis B                                 

• Kung-Hao Liang1,2,a,
• Chao-Wei Hsu1,a,
• Ming-Ling Chang1,
• Yi-Cheng Chen1,
• Ming-Wei Lai1 and
• Chau-Ting Yeh1,2
  

                  

• 1Liver Research Center, Chang Gung Memorial Hospital
• 2Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
  

                  

• Correspondence: C.-T. Yeh, Liver Research Center, Chang Gung Memorial Hospital, 199, Tung Hwa North Rd, Taipei, Taiwan (chautingy{at}gmail.com).
  

                  

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  Presented in part: 50th International Liver Congress, Vienna, Austria, 22–26 April 2015. Abstract RS-1431.

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  ↵a K.-H. L. and C.-W. H. contributed equally to the study.                        

  
  

               
                                 Abstract                  

Background. Clinical factors associated with hepatocellular carcinoma (HCC) have been extensively studied in antiviral treatment–naive patients with chronic hepatitis B virus (HBV) infection but not in treatment-experienced patients. Owing to the wide availability of antiviral agents that effectively suppress HBV replication, we investigated HCC risk factors in treatment-experienced patients.                  

                  

Methods. In a cohort of 330 patients who underwent pretherapeutic liver biopsy, we analyzed the HCC incidence in relationship to clinical parameters. Ultra-deep sequencing of the viral genome was performed on 11 entecavir-treated and pegylated interferon (peginterferon)–treated patients.                  

                  

Results. Initial univariate/multivariate explorations indicated that cirrhosis and antiviral treatment were independently  with HCC occurrence. The peginterferon-experienced patients had a lower HCC incidence than the nucleos(t)ide analogue–patients (P = .011). The peginterferon and entecavir monotherapy groups also differed in HCC incidence (P = .018). Results of analysis of baseline-matched subgroups concurred with cohort analysis (P = .009 for comparison of peginterferon-experienced vs nucleotide analogue–treated patients; P = .022 for comparison of peginterferon- vs entecavir-treated patients). Viral loads of entecavir-treated patients were constantly suppressed to levels lower than those of peginterferon-treated patients (P < .001). Oncogenic surface antigen truncation mutations were detected in entecavir-treated patients with HCC but not in peginterferon-treated patients (P = .015).                  

                  

Conclusions. Treatment by peginterferon was associated with a lower HCC incidence than nucleos(t)ide-analogue treatment in chronic HBV infection.                  

               

StephenW

聚乙二醇干扰素是优于慢性乙肝核苷（酸）类似物预防肝癌

    龚浩Liang1,2，一，超威Hsu1，一，明陵Chang1，易诚臣1，明伟Lai1和筹庭Yeh1,2

    1Liver研究中心，长庚医院
    2Molecular医学研究中心，长庚大学，台湾桃园

    函授：C.-T.叶，肝脏研究中心，长庚医院，199，通华北路，台北，台湾（chautingy {}在gmail.com）。

    提出部分：第50届国际肝病会议上，奥地利维也纳，4月22-26日2015摘要RS-1431。

    ↵aK.-H. L.和C.-W. H.同等贡献的研究。

抽象

背景。与肝细胞癌（HCC）相关的临床因素已被广泛研究的抗病毒治疗的初治患者的慢性乙型肝炎病毒（HBV）感染，但没有治疗经验的患者。由于抗病毒药物能有效地抑制乙肝病毒复制的广泛可用性，我们研究肝癌危险因素的治疗经验的患者。

方法。在330名患者谁接受治疗前肝活检一个队列中，我们分析了肝癌发病率的关系临床参数。 11恩替卡韦治疗和聚乙二醇干扰素（聚乙二醇干扰素）处理的患者中进行病毒基因组的超深度测序。

结果。最初的单变量/多变量的探索表明，肝硬化和抗病毒治疗独立与肝癌发生有关。聚乙二醇干扰素经验的患者有较低的肝癌发病率比核苷（酸）类似物IDE治疗的患者（P = 0.011）。聚乙二醇干扰素和恩替卡韦单药治疗组也有不同的肝癌发病率（P = 0.018）。的基线匹配亚组分析的结果，同意队列分析（P = 0.009聚乙二醇干扰素经验的VS核苷酸类似物治疗的患者的比较，P = 0.022对于peg干扰素比较VS恩替卡韦治疗的患者）。恩替卡韦治疗的患者的病毒载量不断打压的水平高于聚乙二醇干扰素治疗的患者降低（P <0.001）。在恩替卡韦治疗的肝癌患者进行检测，但不是在聚乙二醇干扰素治疗的患者（P = 0.015）致癌表面抗原截短突变。

结论。治疗聚乙二醇干扰素与较低的肝癌发病率比核苷（酸）的慢性HBV感染的IDE类似物治疗有关。