血清乙型肝炎 DNA < 2000 IU/mL 的失代償期肝硬化的自然史

StephenW

血清乙型肝炎 DNA < 2000 IU/mL 的失代償期肝硬化的自然史：一項回顧性研究

    黃旭、顏美美、鄧澤潤、姚磊、韓丹、孫麗華

BMC Gastroenterology 第 22 卷，文章編號：452 (2022) 引用本文

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抽象的
背景和目標

HBV DNA 水平低（< 2000 IU/mL）、HBV DNA 陰性、HBsAg 陰性乙型肝炎病毒（HBV）感染的患者仍可進展為失代償期肝硬化；然而，目前此類患者，尤其是初治患者的臨床研究數據不足。本研究評估了上述患者的自然病史。
方法

我們回顧性分析了 250 例未接受抗病毒藥物治療的 HBV 相關失代償期肝硬化（HBV DNA < 2000 IU/mL）患者的資料。
結果

250 例患者的平均年齡為 53.90 ± 11.73 歲，其中男性 183 例（73.2%）。分別在 77 名 (30.8%)、200 名 (80%) 和 137 名 (54.8%) 患者中檢測到 HBV DNA、HBsAg 和 HBeAg 陽性。 HBsAg（優勢比 [OR]，3.303；95% 置信區間 [CI]，1.338-8.152；P = 0.010）和 HBeAg（OR，0.200；95% CI，0.107-0.376；P < 0.001）陽性是HBV DNA 水平低。低HBV DNA水平組肝細胞癌（HCC）（P < 0.001）和門靜脈血栓形成（P = 0.001）的發生率較高。多變量分析顯示，HBV DNA 陽性（OR，3.548；95% CI，1.463-8.604；P = 0.005），HBeAg 陽性（OR，0.080；95% CI，0.022-0.289；P < 0.001）和谷氨酰轉移酶（GGT） （OR，1.003；95% CI，1.000-1.006；P = 0.040）是 HCC 的獨立因素。年齡與肝硬化並發症的發生無關。
結論

HBV DNA < 2000 IU/mL的失代償期肝硬化患者仍有嚴重的肝損傷，並可能出現嚴重的肝硬化並發症。低 HBV DNA 水平患者的 HCC 風險較高。 HBsAg 陽性和 HBeAg 陰性可能與低 HBV DNA 水平的發生有關。

StephenW

Natural history of decompensated cirrhosis with serum hepatitis B DNA < 2000 IU/mL: a retrospective study

    Xu Huang, Meimei Yan, Zerun Deng, Lei Yao, Dan Han & Lihua Sun

BMC Gastroenterology volume 22, Article number: 452 (2022) Cite this article

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Abstract
Background and aims

Patients with low HBV DNA levels (< 2000 IU/mL), HBV DNA negative, and HBsAg-negative hepatitis B virus(HBV)infection can still progress to decompensated cirrhosis; however, clinical research data in such patients, especially treatment-naïve patients, are currently insufficient. This study assessed the natural history of aforementioned patients.
Methods

We retrospectively reviewed the data of 250 patients with HBV-associated decompensated cirrhosis(HBV DNA < 2000 IU/mL) who had not been treated with antiviral medication.
Results

The mean age of the 250 patients was 53.90 ± 11.73 years and 183 patients (73.2%) were male. HBV DNA, HBsAg, and HBeAg positivity was detected in 77 (30.8%), 200 (80%), and 137 (54.8%) patients, respectively. HBsAg (odds ratio [OR], 3.303; 95% confidence interval [CI], 1.338–8.152; P = 0.010) and HBeAg (OR, 0.200; 95% CI, 0.107–0.376; P < 0.001) positivity were independent factors for low HBV DNA levels. The incidence of hepatocellular carcinoma (HCC) (P < 0.001) and portal vein thrombosis (P = 0.001) was higher in the low HBV DNA levels group. Multivariate analysis showed that HBV DNA positivity (OR, 3.548; 95% CI, 1.463–8.604; P = 0.005), HBeAg positivity (OR, 0.080; 95% CI, 0.022–0.289; P < 0.001), and glutamyltransferase (GGT) (OR, 1.003; 95% CI, 1.000–1.006; P = 0.040) were independent factors for HCC. Age was not related to the occurrence of cirrhosis complications.
Conclusion

Patients with decompensated cirrhosis with HBV DNA < 2000 IU/mL still had severe liver damage and could develop severe cirrhosis complications. HCC risk was higher in low HBV DNA levels patients. HBsAg positivity and HBeAg negativity may be associated to the occurrence of low HBV DNA levels.

StephenW

https://bmcgastroenterol.biomedc ... /s12876-022-02541-1