重症乙型肝炎爆发,在取消核类同类药物后出现肝脏衰减:基于人口的队列研究
Yao-Chun Hsu1,2,3,4,5, Yi-Hsian Lin4, Teng-Yu Lee6,7
1Division of Gastroenterology and Hepatology, E-Da Hospital, Kaohsiung, Taiwan.
Alimentary pharmacology & therapeutics
|June 21, 2023
概括
在慢性乙型肝炎 (CHB) 治疗中,终止有限核类相应物 (NUC) 治疗可能会导致1-2%的患者出现严重的发作. 风险因素包括肝硬化,门高血压,年龄较大和男性性别,这表明在常规护理中不建议中止NUC.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 临床医学 临床医学
背景情况:
- 有限核酸类比 (NUC) 疗法是治疗慢性乙型肝炎 (CHB) 的新兴策略.
- 了解与停止NUC治疗相关的风险对于患者管理至关重要.
研究的目的:
- 在现实临床环境中确定NUC停止后严重肝炎爆发的发生率.
- 为了确定与NUC停药后严重爆发相关的风险因素.
主要方法:
- 一项以人口为基础的队列研究包括10,192名患者,他们至少一年接受了第一线NUC.
- 竞争的风险分析被用来评估事件发生率和严重爆发的风险因素与肝脏不补偿.
主要成果:
- 4年累计发生的严重爆发与肝脏不补偿的发生率为1.8% (95% CI,1.5%-2.2%).
- 确定的重大危险因素包括肝硬化 (aSHR,2.74),门高血压 (aSHR,2.46),年龄较大 (aSHR,1.21每十年) 和男性性别 (aSHR,1.58).
- 在没有肝硬化或门性高血压的患者中,4年发生率为1.3% (95% CI,1.0%-1.7%).
结论:
- 在临床实践中,NUC停止后的严重爆发发生在CHB患者的1-2%中.
- 肝硬化,门高血压,年龄较大和男性性别是严重爆发的关键风险因素.
- 这些发现不支持CHB管理中的常规NUC停止.
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