选择性5-羟色胺再摄取抑制剂和乙型肝炎病毒感染患者肝细胞

StephenW

Selective serotonin reuptake inhibitors and the risk of hepatocellular carcinoma in hepatitis B virus-infected patients         

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                                                                                Authors Chang CM, Hsieh MS, Yang TC, Hsieh VC, Chiang JH, Huang HH, How CK, Hu SY, Yen DH        
                                    Received 2 August 2017            
                            Accepted for publication 25 October 2017            
                                Published 28 November 2017                            Volume 2017:9                                Pages 709—720                        
                                    DOI https://doi.org/10.2147/CMAR.S148097            
                                        Checked for plagiarism Yes            
                                        Review by Single-blind            
                                                Peer reviewers approved by Dr Colin Mak               
                                            Peer reviewer comments 2            
                                        Editor who approved publication:                                     Dr Leylah Drusbosky                                
               
   
                                                        Chia-Ming Chang,1–3 Ming-Shun Hsieh,1–4 Tsung-Chieh Yang,3,5 Vivian Chia-Rong Hsieh,6 Jen-Huai Chiang,7 Hsien-Hao Huang,1,3 Chorng-Kuang How,1,3 Sung-Yuan Hu,8 David Hung-Tsang Yen1,3

1Department of Emergency Medicine, Taipei Veterans General Hospital, 2Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, 3College of Medicine, National Yang-Ming University, Taipei, 4Department of Emergency Medicine, 5Division of Gastroenterology, Department of Internal Medicine, Taipei Veterans General Hospital, Taoyuan Branch, Taoyuan, 6Department of Health Services Administration, 7Management Office for Health Data, China Medical University, 8Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China

Background: This study aimed to investigate the association between the use of selective serotonin reuptake inhibitors (SSRIs) and the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV) infection.
Methods: We conducted a population-based cohort study by using claims data from the Taiwan National Health Insurance Research Database (NHIRD). The study cohort comprised 1380 newly diagnosed HBV-infected patients with SSRI use who were frequency matched by age, sex, liver cirrhosis, and index year with HBV-infected patients without SSRI use in the comparison cohort. Each patient case was followed from 2000 to 2012 to identify incident HCC cases. Cox proportional hazards regression was performed to evaluate the association between SSRI use and HCC risk. The further sensitivity analysis used case-control study design. A total of 9070 HCC subjects retrieved from NHIRD, and equal non-HCC subjects were analyzed after matching for age and sex.
Results: We identified 9 and 24 HCC cases in the study and comparison cohorts during the follow-up period of 7056 and 6845 person-years, respectively. The incidence rate of HCC was 1.28 and 3.51 per 1000 person-years for SSRI and non-SSRI users, respectively. After adjusting for potential confounders, the adjusted hazard ratio (HR) for SSRI use was 0.28 (95% confidence interval [CI], 0.12–0.64; p = 0.0027). For SSRI users with a cumulative defined daily dose (cDDD) of 28–89, 90–364, and ≥365, the adjusted HRs were 0.51, 0.22, and 0.12, respectively, (95% CI, 0.21–1.25, 0.05–0.94, and 0.02–0.90, respectively) compared with non-SSRI users (<28 cDDD). The sensitivity analysis showed that the SSRI presented with a dose-response protective effect for HCC in the multivariate analysis.
Conclusion: SSRIs use may possibly reduce the risk of HCC in HBV-infected patients in a dose-responsive manner.

Keywords: selective serotonin reuptake inhibitors, SSRI, hepatitis B virus, HBV, hepatocellular carcinoma, HCC, depression

StephenW

选择性5-羟色胺再摄取抑制剂和乙型肝炎病毒感染患者肝细胞癌的风险
         

    抽象
    度量
    获取权限

作者：常CM，Hsieh MS，Yang TC，谢VC，蒋建华，黄HH，CK，胡SY，Yen D

2017年8月2日收到

接受2017年10月25日发布

2017年11月28日发布第2017卷：9页709-720

DOI https://doi.org/10.2147/CMAR.S148097

检查剽窃是的

单盲评审

同行评审由Colin Mak博士批准

同行评审意见2

编辑批准出版物：Leylah Drusbosky博士

谢明辉，杨崇杰，3,5谢伟荣，蒋仁怀，陈仁怀，7，陈孝萱，7，陈光荣， 1,3胡成元，8大卫洪1燕1,3

1台北军区总医院急救医学研究所2台湾大学公共卫生学院职业医学与工业卫生研究所3台湾国立阳明大学医学院4急诊科，5消化内科，内科台湾退伍军人医院桃园分院桃园6医药卫生管理处7中国医科大学卫生统计管理处台湾台中军区总医院急救医学科台湾台中军区总医院

背景：本研究旨在探讨慢性乙型肝炎病毒（HBV）感染患者使用选择性5-羟色胺再摄取抑制剂（SSRIs）与肝细胞癌（HCC）的风险之间的关系。
方法：我们利用台湾国立健康保险研究数据库（NHIRD）的索赔数据进行了基于人群的队列研究。该研究队列包括1380名新诊断为SSRI的乙型肝炎病毒感染患者，年龄，性别，肝硬化和指数年份与频率相匹配的乙型肝炎病毒感染患者与未使用SSRI的患者比较。从2000年到2012年，每个病例都有随访，以确定事件HCC病例。进行Cox比例风险回归评估SSRI使用与HCC风险之间的关联。进一步的敏感性分析采用病例对照研究设计。从NHIRD获得的9070例HCC受试者和等同的非HCC受试者在匹配年龄和性别之后进行分析。
结果：在7056和6845人年的随访期间，我们在研究和比较队列中分别确定了9例和24例HCC病例。 SSRI和非SSRI患者的HCC发病率分别为1.28和3.51 / 1000人年。校正潜在混杂因素后，SSRI使用的调整后危险比（HR）为0.28（95％可信区间[CI]，0.12-0.64; p = 0.0027）。对于累积限定日剂量（cDDD）为28-89,90-364和≥365的SSRI用户，调整后的HR分别为0.51,0.22和0.12（95％CI，0.21-1.25,0.05-0.94 ，和0.02-0.90），与非SSRI用户（<28cDDD）相比。敏感性分析显示SSRI在多变量分析中呈现对HCC的剂量反应保护作用。
结论：SSRIs可能以剂量反应的方式降低HBV感染者的HCC风险。

关键词：选择性5-羟色胺再摄取抑制剂，SSRI，乙型肝炎病毒，HBV，肝细胞癌，HCC，抑郁症

StephenW

意外的结果.