基线病毒载量和治疗期间肝细胞癌风险在慢性乙型肝炎:一个跨国队列研究
Won-Mook Choi1, Terry Cheuk-Fung Yip2, Grace Lai-Hung Wong2
1Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
概括
在治疗期间,乙型肝炎的病毒载量会影响肝癌的风险. 较高的基线病毒载荷可能矛盾地与较低的治疗风险相关,这表明个性化治疗时间是至关重要的.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 在瘤学瘤学.
背景情况:
- 肝细胞癌 (HCC) 仍然是慢性乙型肝炎 (CHB) 患者的风险,即使在抗病毒治疗中.
- 在治疗期间,基线乙型肝炎病毒 (HBV) 病毒载荷对HCC风险的影响尚未完全理解.
研究的目的:
- 调查基线HBV病毒载量与治疗期间HCC风险之间的关联.
- 分析在接受恩特卡维尔或特诺福维尔的非循环性CHB患者中的HCC发病率.
主要方法:
- 多国队列研究包括20826名非肝硬化CHB患者,基线高的HBVDNA.
- 基于基线HBV病毒载量类别的HCC发病率的分层分析.
- 平均随访时间为4.1年.
主要成果:
- 观察到663例HCC病例,发病率为每100人/年0.81.
- 发现了基线HBV病毒载量和HCC风险之间的非线性抛物线关联.
- 在基线病毒载量为6.00-7.00 log10 IU/mL (aHR4.28) 的患者中,HCC风险最高,而在≥8.00 log10 IU/mL的患者中,风险最低.
结论:
- 基线HBV病毒载量在抗病毒治疗期间以非线性,抛物线的方式显著预测HCC风险.
- 以HBV病毒载量为指导的早期抗病毒疗法启动可能会减轻CHB患者的HCC风险累积.
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