慢性乙型肝炎患者与药物诱导的病毒学应答和非活动性携带

StephenW

Liver Int. 2018 Oct 2. doi: 10.1111/liv.13948. [Epub ahead of print]
Fibrosis-matched outcomes between chronic hepatitis B patients with drug-induced virological response and inactive carriers.
Kim HS1, Baatarkhuu O1,2, Lee HW1,3, Park JY1,3,4, Kim DY1,3,4, Ahn SH1,3,4, Song K5, Han KH1,3,4, Kim BK1,3,4, Kim SU1,3,4.
Author information

1
    Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
2
    Department of Infectious Diseases, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
3
    Yonsei Liver Center, Severance Hospital, Seoul, Korea.
4
    Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
5
    Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea.

Abstract
BACKGROUND & AIMS:

We compared the risk of hepatocellular carcinoma (HCC) development between patients with chronic hepatitis B (CHB) who achieved virological response (VR; HBV-DNA < 2000 IU/mL) with nucleos(t)ide analogues (NUCs) treatment (NUC-VR group) and patients with inactive CHB phase (ICHBP group).
METHODS:

To adjust for imbalances between NUC-VR and ICHBP groups, propensity score matching (PSM) models with 1:1 ratios were performed.
RESULTS:

This study included 2032 patients (n = 1291 in NUC-VR group and n = 741 in ICHBP group). Before PSM, NUC-VR group was at higher risk of HCC development than ICHBP group at 7 years (9.4% in NUC-VR group vs 3.3% in ICHBP group; P < 0.001). However, after PSM, the cumulative HCC development rates at 7 years were similar in NUC-VR and ICHBP groups using the three PSM models [2.0% vs 4.3%, PSM model-1 (612 pairs); 3.7% vs 4.4%, PSM model-2 (618 pairs); and 2.4% vs 4.3%, PSM model-3 (610 pairs)] (all P > 0.05).
CONCLUSIONS:

After adjusting heavier hepatic fibrosis burden in NUC-VR group, overall clinical outcomes between 2 groups had become comparable. Therefore, if appropriate, NUCs to prevent viral replication and hepatic inflammation are required for achieving better prognosis.

© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
KEYWORDS:

fibrosis; hepatitis B; hepatocellular carcinoma; matching; prognosis

PMID:
    30280461
DOI:
    10.1111/liv.13948

StephenW

肝脏国际2018年10月2日doi：10.1111 / liv.13948。 [提前打印]
慢性乙型肝炎患者与药物诱导的病毒学应答和非活动性携带者之间的纤维化匹配结果。
Kim HS1，Baatarkhuu O1,2，Lee HW1,3，Park JY1,3,4，Kim DY1,3,4，Ahn SH1,3,4，Song K5，Han KH1,3,4，Kim BK1,3,4 ，金SU1,3,4。
作者信息

1
    韩国延世大学医学院内科，韩国首尔。
2
    蒙古国立医科大学传染病系，蒙古乌兰巴托。
3
    韩国首尔Severance医院延世肝脏中心。
4
    韩国首尔延世大学医学院消化内科研究所。
五
    韩国首尔延世大学医学院生物统计学系。

抽象
背景与目的：

我们比较了实现病毒学应答（VR; HBV-DNA <2000 IU / mL）的慢性乙型肝炎（CHB）患者与核苷（酸）类似物（NUCs）治疗（NUC-）之间肝细胞癌（HCC）发展的风险VR组）和CHB期非活动期（ICHBP组）。
方法：

为了调整NUC-VR和ICHBP组之间的不平衡，进行具有1：1比率的倾向评分匹配（PSM）模型。
结果：

该研究包括2032名患者（NUC-VR组中n = 1291，ICHBP组中n = 741）。在PSM之前，NUC-VR组在7年时的HCC发展风险高于ICHBP组（NUC-VR组为9.4％，ICHBP组为3.3％; P <0.001）。然而，在PSM之后，使用三种PSM模型在NUC-VR和ICHBP组中7年的累积HCC发展率相似[2.0％对4.3％，PSM模型-1（612对）; 3.7％vs 4.4％，PSM model-2（618对）;和2.4％对4.3％，PSM模型-3（610对）]（所有P> 0.05）。
结论：

在调整NUC-VR组中较重的肝纤维化负荷后，两组之间的总体临床结果具有可比性。因此，如果合适，需要NUC来预防病毒复制和肝脏炎症以实现更好的预后。

©2018 John Wiley＆Sons A / S.由John Wiley＆Sons Ltd.出版
关键词：

纤维化;乙型肝炎;肝细胞癌;匹配;预测

结论：
    30280461
DOI：
    10.1111 / liv.13948