在接受贝拉塔塞普特治疗的移植患者中,乙型肝炎病毒的重新激活
Chloë Schwarz1, Antoine Morel2, Marie Matignon2
1Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France.
Kidney international reports
|August 7, 2023
概括
乙型肝炎病毒 (HBV) 再激活发生在接受贝拉塔塞普的移植患者中的21.9%. 虽然重新激活率很高,但它没有显著影响患者或移植的存活率.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 肝病学 肝病学是一种肝病学.
- 免疫学 免疫学 免疫学
背景情况:
- 乙型肝炎病毒 (HBV) 再激活是移植受体的已知风险,通常影响3-9%的抗HBc抗体 (HBcAb) 阳性,HBs抗原 (HBsAg) 阴性患者.
- 在接受选择性辅助刺激阻断剂贝拉塔塞普的患者中,HBV重新激活的发生率以前没有被研究过.
研究的目的:
- 为了研究用belatacept治疗的移植接受者的HBV再激活率.
- 分析结果并确定与该患者群体中HBV重新激活相关的风险因素.
主要方法:
- 在法国两个移植中心进行了一项回顾性研究.
- 分析了135名接受贝拉塔塞普治疗的移植患者的数据,重点关注HBcAb阳性个体.
主要成果:
- 在32名HBcAb阳性患者中,有7名 (21.9%) 患者经历了HBV再激活,其中5例 (16.7%) 发生在HBsAg阴性患者中.
- 移植后的中位数为54.8个月,发生了重新激活. 一名患者患有严重的肝炎,另一个患有肝硬化.
- 在经历HBV再激活和没有经历HBV再激活的患者之间,在5年患者或移植存活时间上没有观察到统计学上显著的差异. 抗病毒预防和HBsAb阳性并没有与活性化风险的降低有关.
结论:
- 与历史数据相比,接受贝拉塔塞普治疗的移植患者的HBV再激活率较高.
- 尽管反应率高,但HBV在这个队列中没有对患者或移植存活产生负面影响.
- 需要进一步的研究来证实这些发现,应该考虑对接受贝拉的HBcAb阳性患者进行系统的抗病毒预防.
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