韩国慢性乙型肝炎患者恩替卡韦前5年及以后的肝细胞癌风险

StephenW

Liver Int. 2018 Jul 27. doi: 10.1111/liv.13938. [Epub ahead of print]
The risk of hepatocellular carcinoma within and beyond the first 5 years of entecavir in Korean patients with chronic hepatitis B.
Kim BG1, Park NH1, Lee SB1, Jeon S2, 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.
2
    Statistical Consulting Laboratory Department of Mathematical Sciences, University of Texas at El Paso, USA.

Abstract
BACKGROUND AND AIMS:

The development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) has decreased due to potent antiviral agents. However, it remains uncertain whether the risk of HCC will diminish after long-term antiviral therapy in Asia, where CHB is endemic and vertical transmission is common. This study aimed to compare the incidence of HCC within and beyond the first 5 years of entecavir (ETV) in treatment-naïve Korean patients with CHB.
METHODS:

We performed a retrospective observational analysis of data from 894 consecutive, adult patients with CHB undergoing ETV treatment at a tertiary referral hospital in Ulsan, Korea from January 1, 2007 through April 31, 2017. We compared the HCC incidence rates per 100 person-years within and beyond the first 5 years. Univariate and multivariate analyses for factors predictive of HCC were performed.
RESULTS:

The incidence rate of HCC in patients with CHB did not differ statistically when we compared within and beyond the first 5 years of ETV therapy (2.29% vs. 1.66% per person-year, p = 0.217). Failure to achieve maintained virologic response (MVR) was a major independent risk factor for HCC in patients at a follow-up of <5 years. In contrast, in patients with a follow-up of ≥5 years, achieving MVR was not significantly associated with HCC development.
CONCLUSIONS:

The incidence rate of HCC may not change significantly before and after 5 years of ETV therapy in Korean CHB patients. The risk of HCC in Asian CHB patients may remain in the long term. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.
KEYWORDS:

Antiviral Therapy; Hepatitis B virus; Hepatocellular Carcinoma; Liver Cirrhosis

PMID:
    30052303
DOI:
    10.1111/liv.13938

StephenW

肝脏国际2018年7月27日doi：10.1111 / liv.13938。 [提前打印]
韩国慢性乙型肝炎患者恩替卡韦前5年及以后的肝细胞癌风险
Kim BG1，Park NH1，Lee SB1，Jeon S2，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。
2
    德克萨斯大学埃尔帕索分校数学科学系统计咨询实验室。

抽象
背景和目的：

由于有效的抗病毒剂，慢性乙型肝炎（CHB）患者的肝细胞癌（HCC）的发展已经减少。然而，仍然不确定在亚洲长期抗病毒治疗后，HCC的风险是否会降低，其中CHB是地方病并且垂直传播很常见。本研究旨在比较恩替卡韦（ETV）前5年内治疗初治韩国CHB患者的HCC发生率。
方法：

我们通过4月31日进行的数据进行了回顾性观测分析，从894连续，成人慢性乙肝患者在韩国蔚山的三级转诊医院从2007年1月1日，在经过治疗ETV，2017年我们比较每100人年的肝癌发病率在前5年内和之后。进行了预测HCC因子的单变量和多变量分析。
结果：

当我们在ETV治疗的前5年内和之后进行比较时，CHB患者中HCC的发生率没有统计学差异（2.29％对每人每年1.66％，p = 0.217）。在随访<5年的患者中，未能达到维持病毒学应答（MVR）是HCC的主要独立危险因素。相反，对于随访≥5年的患者，实现MVR与HCC发展无显着相关性。
结论：

在韩国CHB患者的ETV治疗5年之前和之后，HCC的发病率可能没有显着变化。亚洲CHB患者的HCC风险可能会长期存在。本文受版权保护。版权所有。

本文受版权保护。版权所有。
关键词：

抗病毒治疗;乙型肝炎病毒;肝细胞癌;肝硬化

结论：
    30052303
DOI：
    10.1111 / liv.13938