肝硬化和非肝硬化慢性乙型肝炎患者肝细胞癌合并替诺福韦

StephenW

Reduced Incidence of Hepatocellular Carcinoma with Tenofovir in Chronic Hepatitis B Patients with and without Cirrhosis - a Propensity Score Matched Study
Mindie H Nguyen, MD, MAS Hwai-I Yang, PhD An Le, BA Linda Henry, PhD Nghia Nguyen, MD, MAS Mei-Hsuan Lee, PhD Jian Zhang, DNP Christopher Wong, MD Clifford Wong, MD Huy Trinh, MD
The Journal of Infectious Diseases, jiy391, https://doi.org/10.1093/infdis/jiy391
Published:
05 July 2018
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Abstract
Background

The effect of newer oral anti-HBV medication, tenofovir disoproxil (TDF), on liver related outcomes among Asians is limited. We examined the effect of TDF on incidence of hepatocellular carcinoma (HCC) within an Asian chronic hepatitis B (CHB) population.
Methods

Retrospective cohort study: 6914 adult, non-transplant, CHB mono-infected patients recruited from 6 U.S. referral, community medical centers, and a community based Taiwan cohort: 774 patients received TDF; 6140 not treated. Propensity score matching [(PSM); age, sex, HBeAg, HBV DNA, ALT, baseline cirrhosis status, follow-up time] balanced the groups (n=591, treated vs. untreated). Kaplan-Meier estimated cumulative risk of HCC. Cox proportional hazards models estimated HCC risk between groups.
Results

The eight-year cumulative HCC incidence was significantly higher in PSM untreated group (20.13% vs 4.69%, p<0.0001). Cirrhosis was a significant predictor for HCC (aHR: 5.36; 95% CI: 2.73 – 10.51, p<0.001). On multivariate analysis adjusting for age, sex, HBV DNA, ALT and study site, TDF was associated with a 77% [0.23 (0.56 – 0.92)] HCC risk reduction in patients with cirrhosis and 73% [0.27 (0.07 – 0.98)] reduction in patients without cirrhosis.
Conclusions

Among cirrhotic and non-cirrhotic Asian CHB patients, TDF therapy was significantly associated with an eight-year HCC cumulative incidence rate reduction.
end stage liver disease, treatment, liver cancer, reduction, tenofovir, hepatitis B

StephenW

肝硬化和非肝硬化慢性乙型肝炎患者肝细胞癌合并替诺福韦的发病率降低 - 倾向评分匹配研究
Mindie H Nguyen，MD，MAS Hwai-I Yang，PhD An Le，BA Linda Henry，PhD Nghia Nguyen，MD，MAS Mei-Hsuan Lee，PhD Jian Zhang，DNP Christopher Wong，MD Clifford Wong，MD Huy Trinh，MD
传染病杂志，jiy391，https：//doi.org/10.1093/infdis/jiy391
发布时间：
2018年7月5日
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抽象
背景

新型口服抗HBV药物替诺福韦地索普西（TDF）对亚洲人肝脏相关结局的影响有限。我们检测了TDF对亚洲慢性乙型肝炎（CHB）人群中肝细胞癌（HCC）发病率的影响。
方法

回顾性队列研究：从6个美国转诊，社区医疗中心和社区台湾队列招募的6914名成人，非移植，CHB单一感染患者：774名患者接受了TDF; 6140没有治疗。倾向得分匹配[（PSM）;年龄，性别，HBeAg，HBV DNA，ALT，基线肝硬化状态，随访时间]平衡各组（n = 591，治疗组与未治疗组）。 Kaplan-Meier估计HCC的累积风险。 Cox比例风险模型估计组间HCC风险。
结果

PSM未治疗组的8年累积HCC发生率显着较高（20.13％对4.69％，p <0.0001）。肝硬化是HCC的重要预测因子（aHR：5.36; 95％CI：2.73 - 10.51，p <0.001）。在调整年龄，性别，HBV DNA，ALT和研究部位的多变量分析中，TDF与肝硬化患者的77％[0.23（0.56 - 0.92）] HCC风险降低相关，73％[0.27（0.07 - 0.98）]减少没有肝硬化的患者。
结论

在肝硬化和非肝硬化的亚洲CHB患者中，TDF治疗与8年HCC累积发病率降低显着相关。
终末期肝病，治疗，肝癌，还原，替诺福韦，乙型肝炎