糖尿病影响慢性乙型肝炎患者的病毒反应:血糖控制作为关键可修改的风险因素
Aoyi Li1, Yan Han1, Guanglin Xiao1
1Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Department of Infectious Diseases, Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing 401336, China.
2型糖尿病 (T2DM) 在慢性乙型肝炎 (CHB) 患者中显著降低了抗病毒治疗的有效性. 在患有T2DM的CHB患者中实现良好的血糖控制可以提高病毒学反应率.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 内分泌学 在内分泌学.
- 病毒学 病毒学
背景情况:
- 慢性乙型肝炎 (CHB) 和2型糖尿病 (T2DM) 经常共存,可能会影响治疗结果.
- 了解T2DM,血糖控制和CHB抗病毒疗法疗效之间的相互作用对于患者管理至关重要.
研究的目的:
- 评估T2DM和血糖控制对中核胺类同类 (NA) 治疗在CHB患者的疗效的影响.
- 为了确定CHB患者治疗NAs的病毒学反应的预测因素.
主要方法:
- 开始NA治疗的未经治疗的CHB患者的回顾性队列研究 (2019年1月 - 2024年1月).
- 主要终点:完整的病毒学反应 (CVR),定义为HBVDNA<20 IU/mL在48周.
- 在T2DM和没有T2DM的CHB患者之间比较CVR率,并分析T2DM子组内影响CVR的因素.
主要成果:
- 患有T2DM的CHB患者的CVR率 (26.0%) 与没有T2DM的患者 (41.2%) 相比显著降低.
- T2DM被确定为CVR的独立负预测因子 (OR = 0.400).
- 在CHB + T2DM患者中,适当的血糖控制 (HbA1c <7%) 与较高的CVR (38.7%与16.7%) 相关.
- 在T2DM的CHB患者中,基于tenofovir的疗法显示出比恩特卡维尔更有利的抗病毒趋势.
结论:
- 伴并发性T2DM损害了CHB患者的抗病毒疗效,这些患者接受了NAs治疗.
- 最佳的血糖控制与T2DMCHB患者的病毒学结果的改善有关.
- 早期诊断和T2DM的管理可以提高抗病毒治疗在CHB患者的疗效.
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