替诺福韦-A倾向评分匹配研究治疗慢性乙型肝炎肝硬化患者肝

StephenW

Reduced Incidence of Hepatocellular Carcinoma in Cirrhotic and Noncirrhotic Patients With Chronic Hepatitis B Treated With Tenofovir—A Propensity Score–Matched Study
Mindie H Nguyen Hwai-I Yang An Le Linda Henry Nghia Nguyen Mei-Hsuan Lee Jian Zhang Christopher Wong Clifford Wong Huy Trinh
The Journal of Infectious Diseases, Volume 219, Issue 1, 1 January 2019, Pages 10–18, https://doi.org/10.1093/infdis/jiy391
Published:
05 July 2018

Abstract
Background

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

This was a retrospective cohort study of 6914 adults with chronic HBV monoinfection and no history of transplantation who were recruited from 6 US referral, community medical centers and a community based Taiwan cohort for a total of 774 patients who received TDF and 6140 who were not treated. Propensity score matching (PSM) for age, sex, HBV e antigen status, HBV DNA level, alanine aminotransferase (ALT) level, baseline cirrhosis status, and follow-up time was performed to balance the groups, resulting in 591 treated individuals and 591 untreated individuals. Kaplan-Meier analysis was used to estimate the cumulative risk of HCC. Cox proportional hazards models were run to estimate the HCC risk between groups.
Results

The 8-year cumulative HCC incidence was significantly higher in the PSM untreated group (20.13% vs 4.69%; P < .0001). Cirrhosis was a significant predictor for HCC (adjusted hazard ratio [aHR], 5.36; 95% confidence interval [CI], 2.73–10.51; P < .001). On multivariate analysis adjusted for age, sex, HBV DNA level, ALT level, and study site, TDF was associated with a 77% reduction in the risk of HCC (aHR, 0.23; 95% CI, .56–.92) in patients with cirrhosis and a 73% reduction (aHR, 0.27; 95% CI, .07–.98) in patients without cirrhosis.
Conclusions

Among cirrhotic and noncirrhotic Asian patients with CHB, TDF therapy was significantly associated with a reduction in the 8-year HCC cumulative incidence rate.
End-stage liver disease, hepatitis B, liver cancer, reduction, tenofovir, treatment
Topic:

    liver cirrhosis carcinoma, hepatocellular hepatitis b, chronic hepatitis b virus tenofovir asian

Issue Section:
Viruses

StephenW

替诺福韦-A倾向评分匹配研究治疗慢性乙型肝炎肝硬化患者肝细胞癌发病率降低
Mindie H Nguyen Hwai-I Yang An Le Linda Henry Nghia Nguyen Mei-Hsuan Lee Jian Zhang Christopher Wong Clifford Wong Huy Trinh
Journal of Infectious Diseases，第219卷，第1期，2019年1月1日，第10-18页，https：//doi.org/10.1093/infdis/jiy391
发布时间：
2018年7月5日

抽象
背景

新型口服抗乙型肝炎病毒（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。我们研究了TDF对亚洲慢性乙型肝炎（CHB）人群肝细胞癌（HCC）发病率的影响。
方法

这是一项回顾性队列研究，对6914名患有慢性HBV单一感染且无移植史的成人进行了研究，这些成人来自6个美国转诊，社区医疗中心和社区台湾队列，共有774名接受TDF的患者和6140名未接受治疗的患者。进行年龄，性别，HBV e抗原状态，HBV DNA水平，丙氨酸氨基转移酶（ALT）水平，基线肝硬化状态和随访时间的倾向评分匹配（PSM）以平衡各组，产生591个治疗个体和591个未经治疗的人。 Kaplan-Meier分析用于估计HCC的累积风险。运行Cox比例风险模型来估计组间的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 <.0001）。肝硬化是HCC的重要预测因子（校正风险比[aHR]，5.36; 95％置信区间[CI]，2.73-10.51; P <.001）。根据年龄，性别，HBV DNA水平，ALT水平和研究部位调整的多变量分析，TDF与患者HCC风险降低77％（aHR，0.23; 95％CI，.56-.92）相关在没有肝硬化的患者中，肝硬化和减少73％（aHR，0.27; 95％CI，.07-.98）。
结论

在患有CHB的肝硬化和非肝硬化亚洲患者中，TDF治疗与8年HCC累积发病率的降低显着相关。
终末期肝病，乙型肝炎，肝癌，还原，替诺福韦，治疗
话题：

    肝硬化癌，肝细胞乙型肝炎，慢性乙型肝炎病毒tenofovir亚洲

问题部分：
病毒

StephenW

https://academic.oup.com/jid/article/219/1/10/5049301