恩替卡韦降低慢性乙型肝炎肝细胞癌患者血清乙型肝炎核心

StephenW

Entecavir Reduced Serum Hepatitis B Core-Related Antigen in Chronic Hepatitis B Patients With Hepatocellular Carcinoma
Lung-Yi Mak  1 , Kwan-Lung Ko  1 , Wai-Pan To  1 , Danny Ka-Ho Wong  1   2 , Wai-Kay Seto  1   2   3 , James Fung  1   2 , Man-Fung Yuen  1   2
Affiliations
Affiliations

    1
    Department of Medicine, Queen Mary Hospital, The University of Hong Kong, China.
    2
    State Key Laboratory of Liver Research, The University of Hong Kong, Hong Kong, China.
    3
    Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.

    PMID: 32457279 DOI: 10.5009/gnl19434

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Abstract

Serum hepatitis B core-related antigen (HBcrAg) was shown to predict the risk of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients undergoing treatment. We investigated the longitudinal profile of HBcrAg in entecavir (ETV)-treated CHB patients with subsequent HCC development. We identified HCC cases diagnosed at ≥1 year after ETV initiation. CHB patients without HCC (matched for age, sex, cirrhosis status, baseline hepatitis B virus (HBV) DNA level, and ETV treatment duration) were identified as controls at an HCC:non-HCC ratio of 1:2. Serum samples were retrieved at baseline (ETV initiation) and at 3 and 5 years of ETV therapy for HBcrAg measurement (log IU/mL). In total, 180 patients (60 HCC patients matched with 120 CHB patients without HCC; median age, 56.5 years; 80.6% male; baseline HBV DNA, 5.9 log IU/mL; median follow-up, 6.8 years) were recruited. The median time from ETV initiation to HCC development was 3.2 years. HBcrAg levels were higher in HCC cases than in controls at all three time points: 5.69 log IU/mL versus 5.02 log IU/mL (p=0.025), 4.23 log IU/mL versus 3.36 log IU/mL (p=0.007), and 3.86 log IU/mL vs 3.36 log IU/mL (p=0.009), respectively. ETV led to similar rates of decline in HBcrAg from baseline to 3 years in both groups (0.34 log IU/mL/year vs 0.39 log IU/mL/year, p=0.774), although the decline from 3 to 5 years was slower in the non-HCC group (0.05 log IU/mL/year) than in the HCC group (0.09 log IU/mL/year, p=0.055). ETV time-dependently reduced HBcrAg in HCC and non-HCC patients. HBcrAg interpretation should consider the antiviral treatment duration.

Keywords: Chronic hepatitis B; Entecavir; Hepatitis B core-related antigen; Hepatocellular carcinoma.

StephenW

恩替卡韦降低慢性乙型肝炎肝细胞癌患者血清乙型肝炎核心相关抗原
麦龙怡1，关光龙1，围盼盼1，黄家豪1 2，惠威濑户1 2 3，冯德伦1 2，袁文峰1 2
隶属关系
隶属关系

    1个
    中国香港大学玛丽医院医学系。
    2
    香港大学，肝脏研究国家重点实验室，中国香港。
    3
    香港深圳大学附属医院医学系，深圳。

    PMID：32457279 DOI：10.5009 / gnl19434

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抽象

血清乙型肝炎核心相关抗原（HBcrAg）被证明可预测接受治疗的慢性乙型肝炎（CHB）患者的肝细胞癌（HCC）风险。我们调查了恩替卡韦（ETV）治疗的CHB患者随后发生HCC的过程中HBcrAg的纵向分布。我们确定了ETV启动后≥1年诊断出的HCC病例。没有HCC（与年龄，性别，肝硬化状态，基线乙型肝炎病毒（HBV）DNA水平和ETV治疗持续时间相匹配）的CHB患者被确定为HCC：非HCC比为1：2的对照。在基线（ETV起始）以及ETV治疗3年和5年时（HB / mL）（log IU / mL）取血清。总共招募了180例患者（60例HCC患者与120例无HCC的CHB患者；中位年龄为56.5岁；男性为80.6％；基线HBV DNA为5.9 log IU / mL；中位随访时间为6.8年）。从开始ETV到肝癌发展的中位时间为3.2年。在所有三个时间点，HCC患者的HBcrAg水平均高于对照组：5.69 log IU / mL对5.02 log IU / mL（p = 0.025），4.23 log IU / mL对3.36 log IU / mL（p = 0.007），和3.86 log IU / mL分别为3.36 log IU / mL（p = 0.009）。在两组中，ETV导致HBcrAg从基线水平下降到3年的速率相似（0.34 log IU / mL /年vs 0.39 log IU / mL /年，p = 0.774），尽管在3年至5年的下降较慢。非HCC组（0.05 log IU / mL /年）比HCC组（0.09 log IU / mL /年，p = 0.055）。 ETV时间依赖性地降低了HCC和非HCC患者的HBcrAg。 HBcrAg的解释应考虑抗病毒治疗的持续时间。

关键字：慢性乙型肝炎；恩替卡韦;乙肝核心相关抗原；肝细胞癌。

StephenW

http://www.gutnliver.org/journal/view.html?doi=10.5009/gnl19434