AASLD2020[746]抗病毒治疗可改善长期健康 代偿性乙肝病毒感染

StephenW

746
ANTIVIRAL THERAPY IMPROVES LONG-TERM HEALTH
RELATED QUALITY OF LIFE IN COMPENSATED HBV-CIRRHOSIS
PATIENTS
Xiaoning Wu1,2, Jia Hong1,2, Jialing Zhou2, Yameng Sun1,2,
Huiguo Ding3, Wen Xie4, Hongxin Piao5, Xiaoyuan Xu6, Wei
Jiang7, Bo Feng8, Mingyi Xu9, Jilin Cheng10, Xiaojuan Ou2,
Jidong Jia2 and Hong You11, (1)Beijing Friendship Hospital,
Capital Medical University, (2)Liver Research Center, Beijing
Friendship Hospital, Capital Medical University, Beijing Key
Laboratory of Translational Medicine in Liver Cirrhosis, National
Clinical Research Center of Digestive Diseases, Beijing,
China, (3)Department of Gastroenterology and Hepatology,
Beijing You’an Hospital, Capital Medical University, (4)Center
of Liver Diseases, Beijing Ditan Hospital, Capital Medical
University, (5)Infectious Department, Affiliated Hospital of
Yanbian University, Yanji, Jilin, China, (6)Peking University
First Hospital, (7)Department of Gastroenterology, Zhongshan
Hospital, Fudan University, Shanghai, China, (8)Hepatology
Institute, Peking University People’s Hospital, Beijing, China,
(9)Shanghai General Hospital, Shanghai Jiaotong University
School of Medicine, (10)Department of Gastroenterology,
Shanghai Public Health Clinical Center, Fudan University,
Shanghai, China, (11)Liver Research Center
Background: In patients with chronic hepatitis B virus (HBV)
infection, health-related quality of life (HRQOL) deteriorates
with disease progression Patients with compensated HBVcirrhosis
are at high risk of disease progression Antiviral
therapy can reverse some HBV-cirrhosis or reduce risk of
disease progression However, long-term change of HRQOL
in compensated HBV-cirrhosis on-treatment is unknown
Methods: Patients clinically diagnosed as compensated
HBV-cirrhosis were included and initiated entecavir (ETV)
therapy Five years data was collected at baseline and yearly
in clinical, biochemical, virological and imaging assessment
HRQOL was measured by European Quality of Life-5
Dimensions (EQ-5D) and Short Form-36 (SF-36) Logistic
regression was used to evaluate associate factors of HRQOL
improvement Results: A total of 571 patients were enrolled
with median age of 47 (40, 54) years old About 75 1%
patients were male gender and 44 8% were HBeAg positive
During 4 9 (2, 5 9) years of follow-up, sixty-four patients were
censored due to decompensation (n=28) or hepatocellular
carcinoma (n=36) In EQ5D, visual analogue scale (VAS)
score and utility index (UI) increased significantly (VAS:
79 6±16 8 to 85 0±16 8, UI: 0 89±0 11 to 0 92±0 08, both
P<0 001) 5 years on-treatment In SF-36, all eight dimensions
scores increased significantly with physical functioning
(88 4±15 7 to 92 0±10 3, P<0 001), physical role (63 2±40 7
to 72 3±39 9, P<0 001), bodily pain (79 8±19 0 to 84 2±16 8,
P<0 001), general health (53 8±20 6 to 63 9±21 7, P<0 001),
vitality (67 3±19 4 to 74 4±18 4, P<0 001), social functioning
(76 8±20 5 to 82 7±20 1, P<0 001), role emotional (64 4±41 5
to 74 9±38 2, P<0 001), and mental health (65 5±18 2 to
74 8±17 5, P<0 001) Physical component summary (PCS)
and mental component summary (MCS) were derived from
the above eight dimensions in SF-36 Both PCS and MCS
increased significantly 5 years on-treatment (PCS, 47.7±9.8
to 50 8±8 7; MCS, 46 2±11 0 to 50 8±10 4, both P<0 001)
Furthermore, in multivariate analysis, total bilirubin decrease
is associated with PCS improvement and female gender is
associated with MCS improvement at year-five. Conclusion:
Five-year antiviral treatment significantly improves health
related quality of life measured by EQ-5D and SF-36 in
patients with compensated HBV-cirrhosis.

StephenW

746
抗病毒治疗可改善长期健康
代偿性乙肝病毒感染患者的相关生活质量
耐心
吴小宁1,2，贾宏1,2，周嘉玲2，孙亚萌1,2，
丁慧国3，文谢4，朴红新5，徐小元6，魏
江7，博峰8，徐明义9，成吉林10，欧小娟2，
冀东佳2和洪友11，（1）北京友谊医院，
首都医科大学（2）肝脏研究中心，北京
首都医科大学附属友谊医院北京重点
国家肝硬化转化医学实验室
北京市消化系统疾病研究中心
中国（3）胃肠病学和肝病学系，
首都医科大学附属北京佑安医院（4）中心
首都医科大学附属北京地坛医院肝病科
大学（5）附属医院传染科
延边大学，吉林吉林延吉（6）北京大学
中山市第一医院消化内科（7）
复旦大学附属医院，上海，（8）
北京大学人民医院研究所，北京，中国
（9）上海交通大学附属上海总医院
医学院（10）消化内科
复旦大学上海公共卫生临床中心
中国上海（11）肝脏研究中心
背景：患有慢性乙型肝炎病毒（HBV）的患者
感染，与健康有关的生活质量（HRQOL）下降
疾病进展伴代偿性HBV肝硬化患者
处于疾病进展的高风险中抗病毒
治疗可以逆转某些HBV肝硬化或降低患上HBV的风险
疾病进展然而，HRQOL的长期变化
HBV代偿性肝硬化的治疗方法尚不清楚
方法：临床诊断为补偿的患者
包括乙肝肝硬化并启动恩替卡韦（ETV）
治疗在基线和年度收集五年数据
在临床，生化，病毒学和影像学评估中
HRQOL是通过欧洲生活质量5标准进行衡量的
尺寸（EQ-5D）和简短表格36（SF-36）物流
回归用于评估HRQOL的相关因素
改善结果：共纳入571例患者
中位年龄为47岁（40，54）岁大约75 1％
患者是男性，HBeAg阳性的比例为44 8％
在随访的4 9（2，5 9）年中，有64名患者
由于失代偿（n = 28）或肝细胞被检查
癌（n = 36）在EQ5D中，视觉模拟量表（VAS）
得分和效用指数（UI）显着提高（VAS：
79 6±16 8至85 0±16 8，UI：0 89±0 11至0 92±0 08，两者
P <0 001）治疗5年在SF-36中，所有八个尺寸
身体机能分数显着提高
（88 4±15 7至92 0±10 3，P <0 001），身体角色（63 2±40 7
至72 3±39 9，P <0 001），身体疼痛（79 8±19 0至84 2±16 8，
P <0 001），一般健康状况（53 8±20 6至63 9±21 7，P <0 001），
活力（67 3±19 4至74 4±18 4，P <0 001），社会功能
（76 8±20 5至82 7±20 1，P <0 001），角色情感（64 4±41 5
至74 9±38 2，P <0 001）和心理健康（65 5±18 2至
74 8±17 5，P <0 001）物理成分汇总（PCS）
和心理成分摘要（MCS）来自
SF-36中的上述八个尺寸PCS和MCS
治疗5年显着增加（PCS，47.7±9.8
至50 8±8 7; MCS，46 2±11 0到50 8±10 4，均P <0 001）
此外，在多变量分析中，总胆红素减少
与PCS改善相关，女性为
与五年级MCS改善相关。结论：
五年抗病毒治疗显着改善健康
由EQ-5D和SF-36测量的相关生活质量
代偿性HBV肝硬化患者。