J hepatology: 先前曾接触过乙型肝炎病毒的患者在接受糖皮质激素治疗后发生乙型肝炎表面抗原血清逆转

2019-12-29 不详 MedSci原创

全身皮质类固醇可能引起HBV重新激活,但对先前接触过HBV的患者的影响尚不清楚。本项研究旨在研究先前接触过HBV的患者发生HBsAg逆转和肝炎发作的风险。

背景与目标
全身皮质类固醇可能引起HBV重新激活,但对先前接触过HBV的患者的影响尚不清楚。本项研究旨在研究先前接触过HBV的患者发生HBsAg逆转和肝炎发作的风险。

方法
研究人员纳入2001-2010年间HBsAg阴性并接受糖皮质激素治疗的患者。对HBsAg(抗HBs)和/或HBcAg(抗HBc)抗体呈阳性的患者被定义为以前曾接触过HBV。主要终点为HBsAg血清逆转;次要终点是1年时出现肝炎发作(丙氨酸转氨酶>80U/L)。

结果
共有12997例患者符合纳入标准:仅抗HBs阳性(n=10561);仅抗HBc阳性(n=970);抗HBs和抗HBc阳性(n=830)和抗HBs和抗HBc阴性(n=636)。165例患者发生了HBsAg血清逆转。抗HBc阳性的患者仅发生HBsAg逆转的风险较高(1年发生率1.8%),而抗HBs和抗HBc阴性的患者(0%;p=0.014)。先前曾接触过HBV的患者与未接触过的个体相比,肝衰竭的风险也较低(1.1%VS 0.9%)。在每日峰值剂量为20–40 mg(调整后的危险比[HR] 2.19,p= 0.048)或>40mg(aHR 2.11;P= 0.015)时,接受皮质类固醇激素治疗的患者发生肝炎发作的风险开始增加。

结论
在仅抗HBc阳性的HBsAg阴性患者中,每天高剂量的皮质类固醇高剂量会增加发生肝炎发作的风险,而不会导致血清逆转。

原始出处:

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    2019-12-31 gwc384
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目前关于丙型转氨酶升高的小于1岁的乙型肝炎病毒(HBV)感染婴儿的抗病毒治疗方面的数据很少。本项研究旨在评估婴儿期开始的抗病毒治疗的有效性和安全性。

J Hepatology:乙肝患者采用核苷(酸)类似物完全病毒抑制后可减少肝癌的发生

如果在已经实现完全病毒抑制的慢性乙型肝炎(CHB)治疗患者中彻底清除乙型肝炎表面抗原(HBsAg)是否可以获得额外的临床益处目前还不清楚。本项研究比较了使用核苷类似物(NA)治疗后有或没有HBsAg血清清除的患者中肝细胞癌(HCC)和肝脏事件的风险。

BMC Gastroenterology:埃塞俄比亚慢性乙型肝炎治疗患者死亡率的预测因素

撒哈拉以南非洲地区很难获得慢性乙型肝炎(CHB)的抗病毒治疗的机会; 因此,对非洲CHB患者开始治疗后的预后知之甚少。在这项研究中,研究人员旨在评估撒哈拉以南非洲最大的CHB队列这一的埃塞俄比亚的死亡率预测因子。