抗病毒药物诱导的病毒抑制和非活动期慢性乙型肝炎患者之

StephenW

J Viral Hepat. 2018 May 9. doi: 10.1111/jvh.12927. [Epub ahead of print]
Comparison of overall survival between antiviral-induced viral suppression and inactive phase chronic hepatitis B patients.
Cho YY1,2, Lee JH1, Chang Y1, Nam JY1, Cho H1, Lee DH1,3, Cho EJ1, Lee DH4, Yu SJ1, Lee JM4, Kim YJ1, Yoon JH1.
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Abstract

Nucleot(s)ide analogues (NAs) reduce the risk of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients. However, the risk of HCC is reportedly higher for NA-treated patients than for patients in the inactive CHB phase. This study aimed to compare the long-term outcomes of CHB patients with NA-induced viral suppression and those of patients with inactive CHB. This retrospective study involved 1,118 consecutive CHB patients whose HBV DNA level was continuously <2,000 IU/mL during follow up with/without antiviral agents. The patients were classified into inactive CHB (n=373) or NA groups (n=745). The primary endpoint was overall survival. Secondary endpoints included development of HCC and other liver-related events. The median duration of follow up was 41.0 (inter-quartile range=26.5-55.0) months. The difference in overall survival between the NA group vs. the inactive CHB group was not significant (hazard ratio [HR]=0.78; 95% confidence interval [CI]=0.33-1.85; P=0.57). The NA group showed a significantly higher risk of HCC (HR=3.44; 95% CI=1.82-6.52; P<0.01), but comparable risk for non-HCC liver related events (HR=1.02; 95% CI=0.66-1.59; P=0.93), compared with the inactive CHB group. Among patients with cirrhosis, the NA group showed a significantly lower risk of death (HR=0.31; 95% CI=0.097-0.998; P=0.05) and non-HCC liver related events (HR=0.51; 95% CI=0.31-0.83; P<0.01), but a slightly higher risk of HCC (HR=2.39; 95% CI=0.85-6.75; P=0.09), compared to the inactive CHB group. The overall survival of untreated patients with inactive CHB and of CHB patients achieving viral suppression with NA was comparable. However, NA treatment of cirrhotic patients was significantly associated with longer overall survival and lower risk of liver related events. This article is protected by copyright. All rights reserved.
KEYWORDS:

antiviral treatment; chronic hepatitis B; hepatocellular carcinoma; survival

PMID:
    29741286
DOI:
    10.1111/jvh.12927

StephenW

J Viral Hepat。 2018年5月9日doi：10.1111 / jvh.12927。 [电子版提前打印]
抗病毒药物诱导的病毒抑制和非活动期慢性乙型肝炎患者之间总生存期的比较。
Cho YY1,2，Lee JH1，Chang Y1，Nam JY1，Cho H1，Lee DH1,3，Cho EJ1，Lee DH4，Yu SJ1，Lee JM4，Kim YJ1，Yoon JH1。
作者信息
抽象

核苷酸类似物（NAs）降低慢性乙型肝炎（CHB）患者中肝细胞癌（HCC）的风险。然而，NA治疗患者的HCC风险据报道高于非活动CHB患者的风险。本研究旨在比较NA诱导病毒抑制的CHB患者和CHB失活患者的长期预后。这项回顾性研究涉及1,188例连续使用CHB的患者，其随访期间HBV DNA水平持续<2,000 IU / mL，并且使用/不使用抗病毒药物。将患者分为非活动CHB（n = 373）或NA组（n = 745）。主要终点是总体生存。次要终点包括发展HCC和其他肝相关事件。中位随访时间为41.0（四分位间距= 26.5-55.0）个月。 NA组与非活动CHB组之间总生存率的差异不显着（危险比[HR] = 0.78; 95％置信区间[CI] = 0.33-1.85; P = 0.57）。 NA组显示HCC风险显着增高（HR = 3.44; 95％CI = 1.82-6.52; P <0.01），但与非HCC肝脏相关事件的风险相当（HR = 1.02; 95％CI = 0.66-1.59 ; P = 0.93），与非活动CHB组相比。在肝硬化患者中，NA组患者的死亡风险显着降低（HR = 0.31; 95％CI = 0.097-0.998; P = 0.05）和非HCC肝脏相关事件（HR = 0.51; 95％CI = 0.31- 0.83; P <0.01），但与非活动CHB组相比，HCC的风险稍高（HR = 2.39; 95％CI = 0.85-6.75; P = 0.09）。未治疗的CHB失活患者和CHB患者使用NA进行病毒抑制的总体生存率相当。然而，肝硬化患者的NA治疗与更长的总生存期和更低的肝相关事件风险显着相关。本文受版权保护。版权所有。
关键词：

抗病毒治疗;慢性乙型肝炎;肝细胞癌;生存

结论：
    29741286
DOI：
    10.1111 / jvh.12927