恩替卡韦和低遗传障碍抗病毒药物用于乙型肝炎病毒性肝硬

StephenW

J Coll Physicians Surg Pak. 2019 Apr;29(4):317-323. doi: 10.29271/jcpsp.2019.04.317.
Entecavir and Low Genetic Barrier Antiviral Agents for Hepatocellular Carcinoma in Hepatitis B Viral Cirrhosis: Propensity Score Matching.
Li T1, Qu Y1, Wang Y1, Lin C1, Yang B1, Wang L1.
Author information

1
    Department of Infectious Diseases and Hepatology, the Second Hospital of Shandong University, Jinan 250033, China.

Abstract
OBJECTIVE:

To compare the reduction of hepatocellular carcinoma (HCC) risk between long-term treatment of entecavir and low genetic barrier antiviral agents in hepatitis B virus (HBV)-related cirrhotic patients.
STUDY DESIGN:

An observational study.
PLACE AND DURATION OF STUDY:

Department of Infectious Diseases and Hepatology, the Second Hospital of Shandong University, Jinan, China, from October 2008 to October 2016.
METHODOLOGY:

HBV-related cirrhotic patients with antiviral treatment for at least 12 months were consecutively included. Propensity score matching analysis was performed to improve comparability of the data from both entecavir group and the control group. Log-rank test was used to compare influence of various nucleos(t)ide analogs (NAs) for incidence of HCC. Independent risk factors were estimated by multivariable Cox proportional hazards models.
RESULTS:

The total cohort included 207 HBV-related cirrhotic patients, of which 83 patients were treated with entecavir initially. The present study found no statistical difference for the incidence of HCC between entecavir group and the control group in the total cohort (p=0.525). However, the difference became statistically significant (p=0.014) after propensity score matching. Number needed to treat (NNT) were 8 patients, 6 patients and 3 patients at years 2, 3 and 4, respectively. Multivariable Cox regression in propensity score matching cohort revealed older age (HR: 1.066, p=0.041), NAs of low generic barrier (HR: 6.944, p=0.016), NAs resistance (HR: 3.648, p=0.041), and lower platelet counts (<80x10 ⁹/L) (HR: 6.718, p=0.009) as independent risk factors for HCC incidence.
CONCLUSION:

Entecavir is more efficient in reducing the incident HCC risk for HBV-related cirrhotic patients in comparison to low genetic barrier NAs.

PMID:
    30925952
DOI:
    10.29271/jcpsp.2019.04.317

StephenW

J Coll Physicians Surg Pak。 2019年4月; 29（4）：317-323。 doi：10.29271 / jcpsp.2019.04.317。
恩替卡韦和低遗传障碍抗病毒药物用于乙型肝炎病毒性肝硬化的肝细胞癌：倾向得分匹配。
李T1，曲Y1，王Y1，林C1，杨B1，王L1。
作者信息

1
    山东大学第二医院感染性疾病与肝病科，济南250033

抽象
目的：

比较乙型肝炎病毒（HBV）相关肝硬化患者长期治疗恩替卡韦与低遗传屏障抗病毒药物之间肝细胞癌（HCC）风险的降低。
学习规划：

一项观察性研究。
地点和学习期限：

山东大学第二医院感染性疾病与肝病科，济南，2008年10月至2016年10月。
方法：

连续包括抗病毒治疗至少12个月的HBV相关肝硬化患者。进行倾向评分匹配分析以提高恩替卡韦组和对照组数据的可比性。 Log-rank检验用于比较各种核苷（t）ide类似物（NAs）对HCC发病率的影响。通过多变量Cox比例风险模型估算独立风险因子。
结果：

总队列包括207名HBV相关的肝硬化患者，其中83名患者最初接受恩替卡韦治疗。本研究发现恩替卡韦组与对照组之间HCC发生率无统计学差异（p = 0.525）。然而，在倾向得分匹配后，差异变得具有统计学意义（p = 0.014）。需要治疗的人数（NNT）分别为2名，3名和4名患者，6名患者和3名患者。倾向评分匹配队列中的多变量Cox回归显示年龄较大（HR：1.066，p = 0.041），低通用屏障的NA（HR：6.944，p = 0.016），NAs耐药性（HR：3.648，p = 0.041），并且较低血小板计数（<80x10⁹/ L）（HR：6.718，p = 0.009）是HCC发病率的独立危险因素。
结论：

与低遗传障碍的NA相比，恩替卡韦在降低HBV相关肝硬化患者的HCC风险方面更有效。

结论：
    30925952
DOI：
    10.29271 / jcpsp.2019.04.317