慢性乙型肝炎病毒感染患者肝脏疾病的长期预后接受核苷（

StephenW

Eur J Gastroenterol Hepatol. 2019 May 6. doi: 10.1097/MEG.0000000000001434. [Epub ahead of print]
Long-term prognosis of liver disease in patients with chronic hepatitis B virus infection receiving nucleos(t)ide analogue therapy: an analysis using a Markov chain model.
Tada T1,2, Toyoda H1, Yasuda S1, Miyake N1, Kumada T3, Kurisu A2, Ohisa M2, Akita T2, Tanaka J2.
Author information

1
    Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital.
2
    Department of Epidemiology, Infectious Disease Control, and Prevention, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan.
3
    Faculty of Nursing, Gifu Kyoritsu University, Ogaki.

Abstract
AIM:

Even during nucleos(t)ide analogue therapy, development of hepatocellular carcinoma (HCC) has been observed in patients with chronic hepatitis B virus (HBV) infection. We simulated the long-term prognosis of liver disease in patients with chronic HBV who received nucleos(t)ide analogue therapy.
PATIENTS AND METHODS:

A total of 254 patients with chronic HBV receiving nucleos(t)ide analogue therapy were enrolled. Yearly transition probabilities between liver disease states [chronic hepatitis, cirrhosis, HCC, and hepatitis B surface antigen (HBsAg)-negative status] were calculated using a Markov chain model.
RESULTS:

In the analysis of 1-year liver disease state transition probabilities, the development of HCC occurred in men with chronic hepatitis in their 50s (1.8%) and at least 70 years (2.8%) and in patients with cirrhosis in all age groups (40-49, 50-59, 60-69, and ≥70 years). HBsAg-negative status was present in patients with chronic hepatitis in their 50s (1.8%) and 60s (2.6%), and in patients with cirrhosis in their 60s (0.6%). In female patients, the development of HCC occurred in patients with cirrhosis during their 50s (0.8%), 60s (0.8%), and older (4.5%). HBsAg-negative status was simulated in patients with cirrhosis in their 50s (0.8%) and 60s (0.8%). Assuming a chronic hepatitis state at age 40 as the starting condition for simulation over the next 40 years, the probability of developing HCC increased gradually with age in male patients and in female patients after the age of 70 years.
CONCLUSION:

There is a risk of development of HCC in middle-aged men with chronic hepatitis or cirrhosis and older women with cirrhosis even while receiving nucleos(t)ide analogue therapy.

PMID:
    31082998
DOI:
    10.1097/MEG.0000000000001434

StephenW

Eur J Gastroenterol Hepatol。 2019年5月6日doi：10.1097 / MEG.0000000000001434。 [印刷前的电子版]
慢性乙型肝炎病毒感染患者肝脏疾病的长期预后接受核苷（酸）类似物治疗：使用马尔可夫链模型进行分析。
Tada T1,2，Toyoda H1，Yasuda S1，Miyake N1，Kumada T3，Kurisu A2，Ohisa M2，Akita T2，Tanaka J2。
作者信息

1
大垣市立医院消化内科和肝病科。
2
广岛大学生物医学与健康科学研究所流行病学，传染病控制与预防系，日本广岛。
3
大垣岐阜大学护理学部，大垣。

抽象
目标：

即使在核苷（酸）类似物治疗期间，在慢性乙型肝炎病毒（HBV）感染的患者中也观察到肝细胞癌（HCC）的发展。我们模拟了接受核苷（酸）类似物治疗的慢性HBV患者的肝病长期预后。
患者和方法：

共招募了254名接受核苷（酸）类似物治疗的慢性HBV患者。使用马尔可夫链模型计算肝病状态[慢性肝炎，肝硬化，HCC和乙型肝炎表面抗原（HBsAg） - 阴性状态]之间的年度转变概率。
结果：

在1年肝病状态转变概率的分析中，HCC的发展发生在50岁（1.8％）和至少70岁（2.8％）的慢性肝炎男性和所有年龄组的肝硬化患者（40 -49,50-59,60-69和≥70岁）。 HBsAg阴性状态存在于50s（1.8％）和60s（2.6％）的慢性肝炎患者中，以及60s（0.6％）的肝硬化患者中。在女性患者中，HCC的发展发生在50岁（0.8％），60岁（0.8％）和更老（4.5％）的肝硬化患者中。在50岁（0.8％）和60岁（0.8％）的肝硬化患者中模拟HBsAg阴性状态。假设40岁时的慢性肝炎状态是未来40年模拟的起始条件，男性患者和70岁以后女性患者发生HCC的可能性随着年龄的增长而逐渐增加。
结论：

即使在接受核苷类似物治疗时，患有慢性肝炎或肝硬化的中年男性和患有肝硬化的老年女性也存在发展HCC的风险。

结论：
31082998
DOI：
10.1097 / MEG.0000000000001434

无字书

接受核苷类似物治疗可以降低HCC风险。

左罗

治愈药研究不出来，拣这些东东研究意义不大，这些试验数据比起烟客们肺癌的比例低得多了去。所以亿友们一定要冷静看待和客观分析，尽可能避免和减少负面影响。用积极治疗、科学饮食、合理锻炼和良好心态增强自身免疫力，好好的快乐的过好每一天，其它的就听天由命吧！