亚洲慢性乙型肝炎患者按年龄，性别，疾病和治疗状况向肝

StephenW

Transition rates to cirrhosis and liver cancer by age, gender, disease and treatment status in Asian chronic hepatitis B patients

    Matt Liu, Tai-Chung Tseng, […]Mindie H. Nguyen

Hepatology International volume 15, pages71–81(2021)Cite this article

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Abstract
Background

Increasing hepatitis-related mortality has reignited interest to fulfill the World Health Organization’s goal of viral hepatitis elimination by 2030. However, economic barriers have enabled only 28% of countries to implement countermeasures. Given the high disease burden among Asians, we aimed to present age, sex, disease activity and treatment-specific annual progression rates among Asian chronic hepatitis B (CHB) patients to inform health economic modeling efforts and cost-effective public health interventions.
Methods

We analyzed 18,056 CHB patients from 36 centers across the U.S. and seven countries/regions of Asia Pacific (9530 treated; 8526 untreated). We used Kaplan–Meier methods to estimate annual incidence of cirrhosis and hepatocellular carcinoma (HCC). Active disease was defined by meeting the APASL treatment guideline criteria.
Results

Over a median follow-up of 8.55 years, there were 1178 incidences of cirrhosis and 1212 incidences of HCC (297 without cirrhosis, 915 with cirrhosis). Among the 8526 untreated patients (7977 inactive, 549 active), the annual cirrhosis and HCC incidence ranged from 0.26% to 1.30% and 0.04% to 3.80% in inactive patients, and 0.55 to 4.05% and 0.19 to 6.03% in active patients, respectively. Of the 9530 treated patients, the annual HCC rates ranged 0.03–1.57% among noncirrhotic males and 2.57–6.93% among cirrhotic males, with lower rates for females. Generally, transition rates increased with age, male sex, the presence of fibrosis/cirrhosis, and active disease and/or antiviral treatment.
Conclusion

Using data from a large and diverse real-world cohort of Asian CHB patients, the study provided detailed annual transition rates to inform practice, research and public health planning.

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Abbreviations

HBV:

    Hepatitis B virus
CHB:

    Chronic hepatitis B
HCC:

    Hepatocellular carcinoma
APASL:

    The Asian Pacific Association for the Study of the Liver
USA:

    United States of America
ETV:

    Entecavir
TDF:

    Tenofovir disoproxil fumarate
ALT:

    Alanine aminotransferase
FIB-4:

    Fibrosis-4 Index
WHO:

    World Health Organization
SD:

    Standard deviation
IQR:

    Interquartile range
REAL-B:

    Real-world effectiveness from the Asia Pacific Rim Liver Consortium for HBV

StephenW

亚洲慢性乙型肝炎患者按年龄，性别，疾病和治疗状况向肝硬化和肝癌的转化率

    Matt Liu，曾大中，[…] Mindie H. Nguyen

国际肝病杂志第15卷，第71–81（2021）页，引用本文

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抽象的
背景

与肝炎相关的死亡率上升，重新激发了人们对实现世界卫生组织到2030年消除病毒性肝炎的目标的兴趣。然而，经济壁垒仅使28％的国家能够实施对策。鉴于亚洲人的疾病负担很高，我们旨在呈现亚洲慢性乙型肝炎（CHB）患者的年龄，性别，疾病活动和针对特定治疗的年进展率，以为卫生经济建模工作和具有成本效益的公共卫生干预措施提供信息。
方法

我们分析了来自美国36个中心和亚太地区七个国家/地区的18,056名CHB患者（已治疗9530;未治疗8526）。我们使用Kaplan–Meier方法估算肝硬化和肝细胞癌（HCC）的年发病率。符合APASL治疗指南标准定义活动性疾病。
结果

在中位随访期8.55年中，发生了1178例肝硬化和1212例HCC（无肝硬化297例，肝硬化915例）。在8526例未接受治疗的患者（7977例无效，549例活跃）中，非活跃患者的年肝硬化和HCC发生率介于0.26％至1.30％和0.04％至3.80％，活跃患者的年肝硬化和HCC发生率介于0.55至4.05％和0.19至6.03％，分别。在接受治疗的9530名患者中，非肝硬化男性的年HCC发生率在0.03–1.57％之间，而肝硬化男性的年度HCC发生率在2.57–6.93％之间，女性则较低。通常，随着年龄，男性，纤维化/肝硬化以及活动性疾病和/或抗病毒治疗的出现，转换率会增加。
结论

该研究使用了来自亚洲CHB患者的大量真实世界的数据，该研究提供了详细的年度转化率，以为实践，研究和公共卫生计划提供信息。

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缩略语

乙肝病毒：

    乙型肝炎病毒
CHB：

    慢性乙型肝炎
肝癌：

    肝细胞癌
APASL：

    亚太肝病研究协会
美国：

    美国
ETV：

    恩替卡韦
TDF：

    替诺福韦酯富马酸
ALT：

    丙氨酸氨基转移酶
FIB-4：

    纤维化4指数
谁：

    世界卫生组织
SD：

    标准偏差
IQR：

    四分位间距
REAL-B：

    亚太地区肝炎乙肝联盟在现实世界中的有效性