基于干扰素的治疗优于核苷（酸）类似物，可降低高危慢性

StephenW

Expert Opin Biol Ther. 2018 Sep 5. doi: 10.1080/14712598.2018.1518423. [Epub ahead of print]
Interferon-based treatment is superior to nucleos(t)ide analogue in reducing HBV-related hepatocellular carcinoma for chronic hepatitis B patients at high risk.
Ren P1, Cao Z1, Mo R1, Liu Y1, Chen L1, Li Z1, Zhou T1, Lu J1, Liu Y1, Guo Q1, Chen R1, Zhou H1, Xiang X1, Cai W1, Wang H1, Bao S2, Xu Y1, Gui H1, Xie Q1.
Author information

1
    a Department of Infectious Diseases , Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , China.
2
    b Discipline of Pathology , the University of Sydney , New South Wales 2006 , Australia.

Abstract
BACKGROUND:

The effect of nucleos(t)ide analogues (NAs) vs interferon (IFN) on the occurrence of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) is controversial. We assessed whether antiviral strategy affected HCC development in CHB patients at different HCC risks.
METHODS:

1112 CHB patients with antiviral therapy were included in this retrospective study. Patients treated with NAs only were classified into NAs group (n = 682) while those received IFN treatment with or without NAs were defined as the IFN group (n = 430). Propensity score matching (PSM) was applied to minimize baseline differences.
RESULTS:

Thirty-one patients developed HCC during follow-up (median 5.41 years). The cumulative HCC incidence at 10 years was significantly lower in the IFN group than NAs group (2.7% vs 8.0%, p < 0.001). Similar results were obtained in the PSM-cohort. Patients with IFN-based treatment were less likely to develop HCC than those with NAs (Hazard ratio = 0.15; 95% CI 0.04-0.66; p = 0.012). Subgroup analyses demonstrated that this superiority of IFN in reducing HCC development was obvious in patients at high- but not low-risk of HCC.
CONCLUSIONS:

Reduction of HCC development was more significant in CHB patients at higher HCC risk with IFN-based therapy than NAs treatment.
KEYWORDS:

Chronic hepatitis B; Hepatocellular carcinoma; Interferon; Nucleos(t)ide analogues

PMID:
    30182763
DOI:
    10.1080/14712598.2018.1518423

StephenW

专家Opin Biol Ther。 2018年9月5日：doi：10.1080 / 14712598.2018.1518423。 [提前打印]
基于干扰素的治疗优于核苷（酸）类似物，可降低高危慢性乙型肝炎患者的HBV相关肝细胞癌。
Ren P1，Cao Z1，Mo R1，Liu Y1，Chen L1，Li Z1，Zhou T1，Lu J1，Liu Y1，Guo Q1，Chen R1，Zhou H1，Xiang X1，Cai W1，Wang H1，Bao S2，Xu Y1 ，桂H1，谢Q1。
作者信息

1
    上海交通大学医学院瑞金医院感染科，中国。
2
    b澳大利亚新南威尔士州悉尼大学病理学学科。

抽象
背景：

核苷（酸）类似物（NAs）与干扰素（IFN）对慢性乙型肝炎（CHB）肝细胞癌（HCC）发生的影响存在争议。我们评估了抗病毒策略是否会影响不同HCC风险的CHB患者的HCC发展。
方法：

本回顾性研究纳入了1112例抗病毒治疗的CHB患者。仅用NA治疗的患者被分类为NAs组（n = 682），而接受或不用NAs的IFN治疗的患者被定义为IFN组（n = 430）。应用倾向得分匹配（PSM）以最小化基线差异。
结果：

31例患者在随访期间发生HCC（中位数为5.41岁）。 IFN组的10年累积HCC发生率显着低于NAs组（2.7％vs 8.0％，p <0.001）。在PSM组中获得了类似的结果。基于IFN的治疗患者发生HCC的可能性低于患有NAs的患者（危险比= 0.15; 95％CI 0.04-0.66; p = 0.012）。亚组分析表明，在HCC高风险但非低风险的患者中，IFN在降低HCC发展中的这种优势是显而易见的。
结论：

对于基于IFN的治疗，HCC风险高于NAs治疗的CHB患者，HCC发展的减少更为显着。
关键词：

慢性乙型肝炎;肝细胞癌;干扰素; Nucleos（t）ide类似物

结论：
    30182763
DOI：
    10.1080 / 14712598.2018.1518423

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