核苷（酸）类似物治疗乙型肝炎病毒（HBV）e抗原阳性慢性HBV

StephenW

Nucleos(t)ide Analogue Treatment for Patients With Hepatitis B Virus (HBV) e Antigen–Positive Chronic HBV Genotype C Infection: A Nationwide, Multicenter, Retrospective Study
Young Chang Won Hyeok Choe Dong Hyun Sinn Jeong-Hoon Lee Sang Hoon Ahn Hyewon Lee Jae-Jun Shim Dae Won Jun Soo Young Park Joon Yeul Nam ... Show more
The Journal of Infectious Diseases, Volume 216, Issue 11, 12 December 2017, Pages 1407–1414, https://doi.org/10.1093/infdis/jix506
Published:
23 September 2017


Abstract
Background

Antiviral treatment for hepatitis B virus (HBV) e antigen (HBeAg)–positive chronic HBV infection is still controversial. We assessed whether antiviral treatment reduces the risk of liver disease progression in these patients.
Methods

This study included consecutive patients in 8 large-volume hospitals in Korea who tested positive for HBeAg and had an HBV DNA level of >20000 IU/mL, an alanine aminotransferase (ALT) level of <40 IU/L, and no evidence of cirrhosis. The primary end point was the development of hepatocellular carcinoma (HCC), and the secondary end point was the development of cirrhosis.
Results

A total of 484 patients were included: 87 were in the antiviral treatment group, and 397 were in the control group. Baseline liver function was significantly more favorable for the control group. After matching for propensity score to overcome those differences, the antiviral treatment group had a significantly reduced risk for HCC (hazard ratio [HR], 0.234; log-rank P = .046) and cirrhosis (HR, 0.235; log-rank P = .015), compared with the control group. After balancing the baseline characteristics by using inverse probability weighting, antiviral therapy significantly decreased the risk of HCC (HR, 0.189; log-rank P = .004) and cirrhosis (HR, 0.347; log-rank P = .036).
Conclusion

Antiviral therapy for patients with HBeAg-positive chronic HBV infection and have a high HBV load reduces the risk of HCC, even if the ALT level is below the upper limit of normal.
Issue Section:
Viruses
© The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected].

StephenW

核苷（酸）类似物治疗乙型肝炎病毒（HBV）e抗原阳性慢性HBV基因型C感染的患者：全国性，多中心，回顾性研究
杨昌元贺赫崔东贤辛恩郑勋勋李相勋安贤元李在均大元俊俊秀朴俊儒南...显示更多
“传染病杂志”第216卷，第11期，12月12日，第1407-1414页，https://doi.org/10.1093/infdis/jix506
发布时间：
2017年9月23日


抽象
背景

乙型肝炎病毒（HBV）e抗原（HBeAg）阳性慢性HBV感染的抗病毒治疗仍然存在争议。我们评估了抗病毒治疗是否降低了这些患者肝脏疾病进展的风险。
方法

本研究纳入了韩国8家大型医院的连续患者，其检测HBeAg阳性，HBV DNA水平> 20000 IU / mL，丙氨酸转氨酶（ALT）水平<40 IU / L，无肝硬化。主要终点是肝细胞癌（HCC）的发展，次要终点是肝硬化的发展。
结果

共纳入484例患者：抗病毒治疗组87例，对照组397例。基线肝功能显着更有利于对照组。在匹配倾向评分以克服这些差异后，抗病毒治疗组HCC风险显着降低（风险比[HR]，0.234; log-rank P = .046）和肝硬化（HR，0.235; log-rank P = .015）与对照组比较。通过使用逆概率加权平衡基线特征后，抗病毒治疗显着降低HCC风险（HR，0.189; log-rank P = .004）和肝硬化（HR，0.347; log-rank P = .036）。
结论

对于HBeAg阳性的慢性HBV感染和高HBV负荷的患者进行抗病毒治疗，即使ALT水平低于正常上限，也能降低HCC的发生风险。
问题部分：
病毒
©作者2017.牛津大学出版社出版的美国传染病协会。版权所有。对于权限，电子邮件：[email protected]。

neilhbver

再次说明大三阳免疫耐受期需要治疗

StephenW

回复 neilhbver 的帖子

不是那么明确. 作者表示，他们的患者人群年龄较大，基因型为C.他们支持治疗，如果患者> 30岁.