日本非活動性乙型肝炎病毒攜帶者的死亡率與一般人群相似

StephenW

日本非活動性乙型肝炎病毒攜帶者的死亡率與一般人群相似
Takashi Kumada 1 , Hidenori Toyoda 2 , Satoshi Yasuda 2 , Takanori Ito 3 , Junko Tanaka 4
隸屬關係
隸屬關係

    1
    日本岐阜縣大垣市岐阜共立大學護理學院護理系。
    2
    日本岐阜縣大垣市大垣市立醫院消化內科和肝病科。
    3
    日本名古屋大學醫學研究生院胃腸病學和肝病學系。
    4
    日本廣島廣島大學生物醫學與健康科學研究所流行病學、傳染病控制和預防系。

    PMID：34665918 DOI：10.1111/hepr.13723

抽象的

目的：由於數量較少，關於乙型肝炎病毒 (HBV) 感染者為肝炎包膜抗原 (HBeAg) 陰性非活性攜帶者 (IC) 的長期結局數據有限。我們將明確定義的 IC 的長期預後與年齡和性別匹配的一般人群對照的長期預後進行了比較。

方法：共納入 526 例在隨訪開始後 1 年內至少 3 次丙氨酸氨基轉移酶（ALT）≤40 U/L 和 HBV DNA ≤4.3 log IU/ml 的 HBeAg 陰性患者作為集成電路。非活動攜帶者分為兩組：A組（n = 332），ALT水平≤30 U/L，HBV DNA水平≤3.3 log IU/ml，B組（剩餘患者，n = 194）。我們確定了 IC 的長期預後，並將其與一般人群對照的長期預後進行了比較。我們還分析了與 IC 中乙型肝炎表面抗原 (HBsAg) 清除和相變相關的因素。

結果：A 組和 B 組之間的肝細胞癌發展或全因、肝臟相關或非肝臟相關死亡率沒有顯著差異。IC 和一般人群之間的全因死亡率沒有顯著差異。低 HBsAg 水平（≤3.0 log IU/ml）和脂肪肝的存在與 HBsAg 清除相關，而高甲胎蛋白水平與相變相關。

結論：明確定義的 IC 的長期預後與一般人群對照相似。此外，ICs 具有高 HBsAg 清除率和低相變率。

關鍵詞：HBV DNA；總人口;乙型肝炎病毒（HBV）；肝炎包膜抗原 (HBeAg);非活動載體；受限平均生存時間 (RMST)。

© 2021 日本肝病學會。

StephenW

Mortality of inactive hepatitis B virus carriers in Japan is similar to that of the general population
Takashi Kumada  1 , Hidenori Toyoda  2 , Satoshi Yasuda  2 , Takanori Ito  3 , Junko Tanaka  4
Affiliations
Affiliations

    1
    Department of Nursing, Faculty of Nursing, Gifu Kyoritsu University, Ogaki, Gifu, Japan.
    2
    Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
    3
    Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
    4
    Department of Epidemiology, Infectious Disease Control, and Prevention, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan.

    PMID: 34665918 DOI: 10.1111/hepr.13723

Abstract

Aims: Data on the long-term outcomes of individuals with hepatitis B virus (HBV) infection who are hepatitis envelope antigen (HBeAg)-negative inactive carriers (ICs) are limited due to small numbers. We compared the long-term prognosis of well-defined ICs with that of age- and gender-matched general population controls.

Methods: A total of 526 HBeAg-negative patients who demonstrated alanine aminotransferase (ALT) level ≤40 U/L and HBV DNA level ≤4.3 log IU/ml at least three times within 1 year after the start of follow-up were enrolled as ICs. Inactive carriers were divided into two groups: Group A (n = 332), whose ALT level was ≤30 U/L and HBV DNA level was ≤3.3 log IU/ml, and Group B (remaining patients, n = 194). We determined the long-term prognosis of ICs and compared it with that of general population controls. We also analyzed factors associated with hepatitis B surface antigen (HBsAg) clearance and phase transition in ICs.

Results: There were no significant differences in hepatocellular carcinoma development or all-cause, liver-related, or non-liver-related mortality between Groups A and B. There was no significant difference in all-cause mortality between ICs and the general population. Low HBsAg level (≤3.0 log IU/ml) and the presence of fatty liver were associated with HBsAg clearance and high alpha-fetoprotein level was associated with phase transition.

Conclusions: The long-term prognosis of well-defined ICs was similar to that of general population controls. In addition, the ICs had a high HBsAg clearance rate and low phase transition rate.

Keywords: HBV DNA; general population; hepatitis B virus (HBV); hepatitis envelope antigen (HBeAg); inactive carrier; restricted mean survival time (RMST).

© 2021 Japan Society of Hepatology.