EASL 2018 FRI-333 纤维化调整长期临床结果的比较 慢性乙型肝炎

StephenW

EASL 2018 FRI-333
Comparison of fibrosis-adjusted long-term clinical outcomes in
patients with minimally active chronic hepatitis B who did not
undergo antiviral therapy vs. those with complete virological
response by antiviral therapy
H.W. Lee, B.K. Kim, S.U. Kim, J.Y. Park, D.Y. Kim, S.H. Ahn, K.-H. Han.
Institute of Gastroenterology, Department of Internal Medicine, Seoul,
Korea, Rep. of South
Email: [email protected]
Backgrounds and Aims: The optimal criteria for commencement of
antiviral therapy in patients with chronic hepatitis B (CHB) remain to
be determined yet. Here, we aimed to compare the risk of
hepatocellular carcinoma (HCC) and liver-related event (LRE)
between patients with minimally active CHB who did not undergo
nucleos(t)ide analog (NUC) therapy according to the current
treatment guidelines (MA group) and those with complete virological
response by NUCs (VR group).
Methods: We enrolled consecutive patients with CHB who underwent
liver stiffness (LS) values by transient elastography between
2006 and 2015. Patients with a history of cirrhosis or hepatocellular
carcinoma at the enrollment were excluded. To adjust for imbalances
between the MA and VR groups, propensity-score matching (PSM)
models with 1:1 ratio were performed based on age, gender, HBeAg,
presence of diabetes, and LS value. Cumulative risks of HCC or LRE
development were assessed using Kaplan-Meier method.
Results: A total of 915 patients were enrolled. The mean agewas 54.2
years old, and 61.2%were male. MAgroup (n = 209) had higher serum
HBV DNA level, alanine aminotransferase (ALT), total bilirubin, LS
value and the lower proportion of positive HBeAg compared to VR
group (n = 706). Regarding HCC development, MA group had the
trend toward the higher risk compared to VR group (p = 0.087).
Regarding LRE development, MA group was at the significantly
higher risk than VR group (p = 0.003). On the contrary, after PSM, 206
pairs were generated, showing the similar risks between two groups
in terms of the cumulative risk of both HCC (p = 0.782) and LRE (p =
0.796) development.
Conclusion: After adjusting the fibrosis degree, the potential
prognostic factor for HCC and LE development, MA group also
showed similar, cumulative risks compared to VR group, supporting
the appropriateness of the current treatment guidelines in patients
with CHB.

StephenW

EASL 2018 FRI-333
纤维化调整长期临床结果的比较
慢性乙型肝炎最小活动的患者没有
接受抗病毒治疗与那些完全病毒学
抗病毒治疗的反应
H.W.李，B.K. Kim，S.U. Kim，J.Y. Park，D.Y. Kim，S.H.安，K.-H.汉。
汉城内科医院消化内科，
韩国，南方共和国
电子邮件：[email protected]
背景和目标：开始的最佳标准
慢性乙型肝炎（CHB）患者的抗病毒治疗依然存在
尚未确定。在这里，我们旨在比较风险
肝细胞癌（HCC）和肝脏相关事件（LRE）
患有最低活动性CHB但未接受治疗的患者之间
根据目前的核苷（酸）类似物（NUC）疗法
治疗指南（MA组）和那些完整的病毒学
NUC（VR小组）的回应。
方法：我们登记了接受CHB的连续患者
通过瞬时弹性成像测量肝硬度（LS）值
2006年和2015年。有肝硬化或肝细胞病史的患者
入选时的癌症被排除在外。调整不平衡
在MA和VR组之间，倾向得分匹配（PSM）
根据年龄，性别，HBeAg，
糖尿病的存在和LS值。 HCC或LRE的累积风险
使用Kaplan-Meier方法评估发育。
结果：共有915名患者入选。平均年龄54.2
岁，61.2％为男性。 MA组（n = 209）血清水平较高
HBV DNA水平，丙氨酸氨基转移酶（ALT），总胆红素，LS
价值和较低比例的阳性HBeAg相比，VR
组（n = 706）。关于HCC发展，MA集团已经有了
与VR组相比风险更高（p = 0.087）。
关于LRE发展，MA集团显着
比VR组风险高（p = 0.003）。相反，在PSM之后，206
产生了对，显示了两组之间的相似风险
以HCC（p = 0.782）和LRE（p =
0.796）发展。
结论：调整纤维化程度后，潜力
HCC和LE发展的预后因素，MA组也是如此
显示出与VR组相似的累积风险，支持
目前治疗指南在患者中的适用性
与CHB。