恩替卡韦与替诺福韦治疗的初治慢性乙型肝炎患者的死亡率

StephenW

J Viral Hepat. 2018 Jul 11. doi: 10.1111/jvh.12971. [Epub ahead of print]
Mortality, liver transplantation, and hepatic complications in patients with treatment-naïve chronic hepatitis B treated with entecavir vs tenofovir.
Kim BG1, Park NH1, Lee SB1, Lee H1, Lee BU1, Park JH1, Jung SW1, Jeong ID1, Bang SJ1, Shin JW1.
Author information

1
    Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

Abstract

Few studies have directly compared the long-term clinical outcomes of entecavir (ETV) and tenofovir disoproxil fumarate (TDF). This study aimed to compare the risk of mortality, liver transplantation, and hepatic complications including hepatocellular carcinoma (HCC) and hepatic decompensation between these drugs in treatment-naïve chronic hepatitis B (CHB). We performed a longitudinal observational analysis of data from 1325 consecutive adult CHB patients with a cumulative adherence of ≥80% to treatment with ETV (n=721) or TDF (n=604) at a tertiary referral hospital in Ulsan, Korea, from January 1, 2007, through April 31, 2017. Among the patients, 708 were analyzed using propensity score matching with a ratio of 1:1. In the follow-up period of up to 5 years, 5 patients (0.4%) died, 3 patients (0.2%) underwent liver transplantation (LT), and 54 patients (4.1%) developed HCC. Hepatic decompensation occurred in 24 (1.8%) patients. ETV therapy did not significantly differ from TDF therapy regarding the risk of liver-related death or LT (HR 0.96; 95% CI, 0.23-4.07; log-rank P=0.955), HCC (HR, 1.36; 95% CI, 0.72-2.56; log-rank P=0.340), and hepatic decompensation (HR, 1.64; 95% CI, 0.67-4.00; log-rank P=0.276). In the 708 propensity-matched pairs, ETV and TDF were also not significantly different with respect to the risk of mortality, LT, and hepatic complications. In this longitudinal observational study of 1325 patients with CHB, ETV and TDF therapy were not significantly different regarding the risk of mortality, HCC, LT, and hepatic decompensation. This article is protected by copyright. All rights reserved.
KEYWORDS:

Entecavir; Hepatic Decompensation; Hepatitis B virus; Hepatocellular Carcinoma; Tenofovir

PMID:
    29998592
DOI:
    10.1111/jvh.12971

StephenW

J病毒肝病。 2018年7月11日doi：10.1111 / jvh.12971。 [提前打印]
恩替卡韦与替诺福韦治疗的初治慢性乙型肝炎患者的死亡率，肝移植和肝脏并发症。
Kim BG1，Park NH1，Lee SB1，Lee H1，Lee BU1，Park JH1，Jung SW1，Jeong ID1，Bang SJ1，Shin JW1。
作者信息

1
    蔚山大学医院内科，蔚山大学医学院，韩国蔚山。

抽象

很少有研究直接比较恩替卡韦（ETV）和替诺福韦地索普西富马酸盐（TDF）的长期临床结果。本研究旨在比较未治疗的慢性乙型肝炎（CHB）中死亡，肝移植和肝脏并发症（包括肝细胞癌（HCC）和肝功能失代偿）的风险。我们对来自1月份在韩国蔚山三级转诊医院接受ETV（n = 721）或TDF（n = 604）治疗的1325例成人CHB患者的累积依从性≥80％进行了纵向观察分析在2007年1月1日至2017年4月31日期间，在患者中，使用倾向得分匹配以1：1的比例分析708。在长达5年的随访期间，5名患者（0.4％）死亡，3名患者（0.2％）接受肝移植（LT），54名患者（4.1％）发生HCC。肝功能失代偿发生在24例（1.8％）患者中。 ETV治疗与TDF治疗在肝脏相关死亡或LT风险方面无显着差异（HR 0.96; 95％CI，0.23-4.07; log-rank P = 0.955），HCC（HR，1.36; 95％CI，0.72） -2.56;对数秩P = 0.340）和肝脏失代偿（HR，1.64; 95％CI，0.67-4.00;对数秩P = 0.276）。在708个倾向匹配对中，ETV和TDF在死亡率，LT和肝脏并发症风险方面也没有显着差异。在这项针对1325名CHB患者的纵向观察性研究中，ETV和TDF治疗在死亡率，HCC，LT和肝功能失代偿的风险方面没有显着差异。本文受版权保护。版权所有。
关键词：

恩替卡韦;肝脏补偿;乙型肝炎病毒;肝细胞癌;替诺福韦

结论：
    29998592
DOI：
    10.1111 / jvh.12971