接受核苷酸类似物治疗的慢性乙型肝炎病毒感染患者的肝病

StephenW

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, Toshifumia,,c; Toyoda, Hidenoria; Yasuda, Satoshia; Miyake, Nozomia; Kumada, Takashib; Kurisu, Akemic; Ohisa, Masayukic; Akita, Tomoyukic; Tanaka, Junkoc
European Journal of Gastroenterology & Hepatology: November 2019 - Volume 31 - Issue 11 - p 1452–1459
doi: 10.1097/MEG.0000000000001434
Original Articles: Hepatology
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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.

StephenW

接受核苷酸类似物治疗的慢性乙型肝炎病毒感染患者的肝病远期预后
马尔可夫链模型的分析

Tada，Toshifumia，c；丰田章男（Hidenoria）；聪的安田;三宅一生，Nozomia;熊田高志； Kurisu，Akemic；大isa（Masayukic）Ohisa；秋田智友;田中市
《欧洲胃肠病学和肝病学杂志》：2019年11月-第31卷-第11期-第1452–1459页
doi：10.1097 / MEG.0000000000001434
原始文章：肝病学
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目的即使在核苷酸模拟疗法中，慢性乙型肝炎病毒（HBV）感染的患者也观察到肝细胞癌（HCC）的发展。我们模拟了接受核苷酸（t）ide类似疗法治疗的慢性HBV患者肝病的长期预后。

患者和方法共有254名接受核苷类似物治疗的慢性HBV患者入组。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]之间的年度转换概率。

结果在对1年肝病状态转变可能性的分析中，HCC的发生发生在50岁（1.8％）和至少70岁（2.8％）的慢性肝炎男性以及所有年龄段的肝硬化患者中（ 40-49、50-59、60-69和≥70岁）。慢性肝炎患者在50年代（1.8％）和60年代（2.6％）以及肝硬化患者在60年代（0.6％）出现HBsAg阴性状态。在女性患者中，肝硬化患者在50s（0.8％），60s（0.8％）和老年（4.5％）期间发生肝癌。在肝硬化患者50s（0.8％）和60s（0.8％）中模拟HBsAg阴性状态。假设在接下来的40年中将40岁的慢性肝炎作为开始模拟的条件，那么70岁以后男性和女性患者中，随着年龄的增长，发生HCC的可能性会逐渐增加。

结论即使接受核苷酸类似物治疗，慢性肝炎或肝硬化的中年男性和肝硬化的老年妇女也有发生肝癌的危险。

小牡丹

抗病毒治疗就是隔靴搔痒。解决不了根本问题。抗病毒药就是亿人的保健品药物，说没有用不对，说能治病有点牵强附会。