关于核苷（酸）类似物抗病毒治疗慢性乙型肝炎患者临床结

StephenW

Epidemiol Infect. 2019 Jan;147:e193. doi: 10.1017/S0950268819000815.
Real-world study on clinical outcomes of nucleos(t)ide analogues antiviral therapy in patients with chronic hepatitis B.
Sun Y1, Zhang Y2, Xu Y1, Shu M2, Bonroy K3, Qiu H2, Cai W1.
Author information

1
    Department of Infectious Diseases,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,China.
2
    Epidemiology, Janssen Research and Development,USA.
3
    Janssen Pharmaceutica NV,Belgium.

Abstract

Nucleos(t)ide analogues (NAs) are widely used for antiviral therapy in patients with chronic hepatitis B (CHB), but real-world data on treatment patterns and long-term clinical outcomes are not always available. Using data from electronic medical records between January 2011 and December 2016 in Shanghai, China, we evaluated patient characteristics, treatment patterns and clinical outcomes in patients with CHB. There were 6688 patients in the study cohort. The incidences of cirrhosis and hepatocellular carcinoma (HCC) were 41.0‰ and 6.8‰ person-years, respectively. There were more cirrhosis and HCC cases among patients who had shorter NA treatment duration (<365 days), or who were less compliant (<80%). In addition, increased risk of cirrhosis and HCC was observed in patients who did not achieve hepatitis B surface antigen (HBsAg) loss/seroconversion. Moreover, patients with cirrhosis developed after antiviral treatments had a higher incidence of HCC (adjusted hazard ratio 15.86, 95% confidence interval 7.35-34.24). Good compliance with treatment and longer treatment duration significantly decreased the risk of developing cirrhosis and HCC. HBsAg loss seemed to be a protective factor for cirrhosis/HCC in NAs-treated patients with CHB, and cirrhosis was a confirmed risk factor for HCC development as expected.
KEYWORDS:

Chronic hepatitis B; cirrhosis; compliance; hepatocellular carcinoma; nucleos(t)ide analogues

PMID:
    31364558
DOI:
    10.1017/S0950268819000815

StephenW

Epidemiol感染。 2019年1月; 147：e193。 doi：10.1017 / S0950268819000815。
关于核苷（酸）类似物抗病毒治疗慢性乙型肝炎患者临床结果的实际研究
Sun Y1，Zhang Y2，Xu Y1，Shu M2，Bonroy K3，Qiu H2，Cai W1。
作者信息

1
上海交通大学医学院附属瑞金医院感染科，中国。
2
流行病学，Janssen Research and Development，USA。
3
比利时Janssen Pharmaceutica NV。

抽象

Nucleos（t）ide类似物（NAs）广泛用于慢性乙型肝炎（CHB）患者的抗病毒治疗，但并不总是能获得有关治疗模式和长期临床结果的真实数据。使用电子病历数据2011年1月至2016年12月在中国上海，我们评估了CHB患者的患者特征，治疗模式和临床结果。该研究队列中有6688名患者。肝硬化和肝细胞癌（HCC）的发病率分别为41.0‰和6.8‰人年。在具有较短NA治疗持续时间（<365天）或较不顺从（<80％）的患者中存在更多的肝硬化和HCC病例。此外，在未达到乙型肝炎表面抗原（HBsAg）丢失/血清转换的患者中观察到肝硬化和HCC风险增加。抗病毒治疗后发生肝硬化的患者HCC发病率较高（校正风险比15 .86， 95％置信区间7.35-34.24）。良好的治疗依从性和较长的治疗时间显着降低了发展为肝硬化和HCC的风险。 HBsAg丢失似乎是NAs治疗的CHB患者肝硬化/ HCC的保护因素，并且肝硬化是HCC发展的确认风险因素，如预期的那样。
关键词：

慢性乙型肝炎;肝硬化;合规性;肝细胞癌;核苷（酸）类似物

结论：
31364558
DOI：
10.1017 / S0950268819000815

StephenW

https://www.cambridge.org/core/s ... hepatitis-b-div.pdf

dxd2017

转阴之后，在随访的这几年，肝硬化和肝癌发生率是0。转阴就是终极目标，大家加油！