J Hepatol:肝硬化患者肝细胞癌的风险和可持续病毒学反应:治疗方案的作用

2017-11-25 MedSci MedSci原创

无干扰素治疗HCC发生的风险较高,这与基线风险因素/患者选择有关,而非与非干扰素治疗方案有关。

研究背景:先前的研究报导接受无干扰素治疗的HCV进展期肝病患者HCC发生的风险较高。本研究的目的是使用来自苏格兰HCV临床数据库的数据来验证和解释这一现象。

研究方法:存在肝硬化的HCC患者,从1997年至2016年在苏格兰接受一疗程抗病毒治疗,获得可持续病毒学应答(SVR)。从接受治疗开始即对这些患者开展随访,直至出现死亡、HCC或到2017年1月份。调整相关辅助因子(包括:人口因素、基线肝病阶段、健康行为,病毒学,以及以前的治疗经历)后,使用Cox回归分析模型比较相关方案治疗后HCC的发生率。通过HCV临床数据库和病历回顾,确定HCC的发生。治疗方案是主要的分析方面,无干扰素治疗方案比较包含干扰素的治疗方案。

研究结果:研究共纳入857例患者,其中,31.7%的患者接受无干扰素治疗方案。接受无干扰素治疗方案的患者具有以下特征:年龄偏大、白种人、血小板减少、无HCV基因3型、有过治疗经历。在随访过程中,46例个体发生HCC。在单变量分析中,无干扰素的治疗方案与HCC风险显著增加有关(HR: 2.48; P=0.021)。然而,对基线因素进行多变量调整后,没有与非干扰素治疗方案相关的风险(aHR: 1.15, P=0.744)。

研究结论:无干扰素治疗HCC发生的风险较高,这与基线风险因素/患者选择有关,而非与非干扰素治疗方案有关。

原始出处
Innes H, Barclay ST, Hayes PC, et al. The risk of hepatocellular carcinoma in cirrhotic patients with hepatitis C and sustained viral response: role of the treatment regimen. J Hepatol, 2017, Nov 15. pii: S0168-8278(17)32429-7. doi: 10.1016/j.jhep.2017.10.033.
本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1863327, encodeId=fe17186332e06, content=<a href='/topic/show?id=c0b68135561' target=_blank style='color:#2F92EE;'>#肝细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81355, encryptionId=c0b68135561, topicName=肝细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Mon Jun 04 06:58:00 CST 2018, time=2018-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905029, encodeId=3ef21905029f3, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Sat Feb 03 03:58:00 CST 2018, time=2018-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426907, encodeId=a5a0142690e00, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Mon Nov 27 10:58:00 CST 2017, time=2017-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603336, encodeId=0b9c1603336fe, content=<a href='/topic/show?id=4800e091642' target=_blank style='color:#2F92EE;'>#病毒学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70916, encryptionId=4800e091642, topicName=病毒学)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ed319029923, createdName=周虎, createdTime=Mon Nov 27 10:58:00 CST 2017, time=2017-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1978611, encodeId=0b4e19e861143, content=<a href='/topic/show?id=3b90e79787f' target=_blank style='color:#2F92EE;'>#细胞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77978, encryptionId=3b90e79787f, topicName=细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Sat Aug 11 18:58:00 CST 2018, time=2018-08-11, status=1, ipAttribution=)]
    2018-06-04 xjy02
  2. [GetPortalCommentsPageByObjectIdResponse(id=1863327, encodeId=fe17186332e06, content=<a href='/topic/show?id=c0b68135561' target=_blank style='color:#2F92EE;'>#肝细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81355, encryptionId=c0b68135561, topicName=肝细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Mon Jun 04 06:58:00 CST 2018, time=2018-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905029, encodeId=3ef21905029f3, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Sat Feb 03 03:58:00 CST 2018, time=2018-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426907, encodeId=a5a0142690e00, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Mon Nov 27 10:58:00 CST 2017, time=2017-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603336, encodeId=0b9c1603336fe, content=<a href='/topic/show?id=4800e091642' target=_blank style='color:#2F92EE;'>#病毒学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70916, encryptionId=4800e091642, topicName=病毒学)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ed319029923, createdName=周虎, createdTime=Mon Nov 27 10:58:00 CST 2017, time=2017-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1978611, encodeId=0b4e19e861143, content=<a href='/topic/show?id=3b90e79787f' target=_blank style='color:#2F92EE;'>#细胞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77978, encryptionId=3b90e79787f, topicName=细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Sat Aug 11 18:58:00 CST 2018, time=2018-08-11, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1863327, encodeId=fe17186332e06, content=<a href='/topic/show?id=c0b68135561' target=_blank style='color:#2F92EE;'>#肝细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81355, encryptionId=c0b68135561, topicName=肝细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Mon Jun 04 06:58:00 CST 2018, time=2018-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905029, encodeId=3ef21905029f3, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Sat Feb 03 03:58:00 CST 2018, time=2018-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426907, encodeId=a5a0142690e00, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Mon Nov 27 10:58:00 CST 2017, time=2017-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603336, encodeId=0b9c1603336fe, content=<a href='/topic/show?id=4800e091642' target=_blank style='color:#2F92EE;'>#病毒学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70916, encryptionId=4800e091642, topicName=病毒学)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ed319029923, createdName=周虎, createdTime=Mon Nov 27 10:58:00 CST 2017, time=2017-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1978611, encodeId=0b4e19e861143, content=<a href='/topic/show?id=3b90e79787f' target=_blank style='color:#2F92EE;'>#细胞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77978, encryptionId=3b90e79787f, topicName=细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Sat Aug 11 18:58:00 CST 2018, time=2018-08-11, status=1, ipAttribution=)]
    2017-11-27 gwc384
  4. [GetPortalCommentsPageByObjectIdResponse(id=1863327, encodeId=fe17186332e06, content=<a href='/topic/show?id=c0b68135561' target=_blank style='color:#2F92EE;'>#肝细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81355, encryptionId=c0b68135561, topicName=肝细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Mon Jun 04 06:58:00 CST 2018, time=2018-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905029, encodeId=3ef21905029f3, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Sat Feb 03 03:58:00 CST 2018, time=2018-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426907, encodeId=a5a0142690e00, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Mon Nov 27 10:58:00 CST 2017, time=2017-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603336, encodeId=0b9c1603336fe, content=<a href='/topic/show?id=4800e091642' target=_blank style='color:#2F92EE;'>#病毒学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70916, encryptionId=4800e091642, topicName=病毒学)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ed319029923, createdName=周虎, createdTime=Mon Nov 27 10:58:00 CST 2017, time=2017-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1978611, encodeId=0b4e19e861143, content=<a href='/topic/show?id=3b90e79787f' target=_blank style='color:#2F92EE;'>#细胞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77978, encryptionId=3b90e79787f, topicName=细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Sat Aug 11 18:58:00 CST 2018, time=2018-08-11, status=1, ipAttribution=)]
    2017-11-27 周虎
  5. [GetPortalCommentsPageByObjectIdResponse(id=1863327, encodeId=fe17186332e06, content=<a href='/topic/show?id=c0b68135561' target=_blank style='color:#2F92EE;'>#肝细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81355, encryptionId=c0b68135561, topicName=肝细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Mon Jun 04 06:58:00 CST 2018, time=2018-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905029, encodeId=3ef21905029f3, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Sat Feb 03 03:58:00 CST 2018, time=2018-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426907, encodeId=a5a0142690e00, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Mon Nov 27 10:58:00 CST 2017, time=2017-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603336, encodeId=0b9c1603336fe, content=<a href='/topic/show?id=4800e091642' target=_blank style='color:#2F92EE;'>#病毒学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70916, encryptionId=4800e091642, topicName=病毒学)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ed319029923, createdName=周虎, createdTime=Mon Nov 27 10:58:00 CST 2017, time=2017-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1978611, encodeId=0b4e19e861143, content=<a href='/topic/show?id=3b90e79787f' target=_blank style='color:#2F92EE;'>#细胞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77978, encryptionId=3b90e79787f, topicName=细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Sat Aug 11 18:58:00 CST 2018, time=2018-08-11, status=1, ipAttribution=)]

相关资讯

Liver Int:索菲布韦在等待进行肝移植的丙型肝炎患者中的疗效

总之,研究结果表明,对于血清HCV-RNA转为阴性时间少于4周或者直到进行肝移植时仍存在病毒血症的患者,桥接抗病毒治疗可以成为病人的一种选择。即使在晚期失代偿性肝硬化患者中,也可以通过治疗,使病情得到改善,达到消除的状态。

CA Cancer J Clin:丙型肝炎病毒感染的肿瘤负担——临床角度

慢性丙型肝炎病毒(HCV)感染影响了全球数百万人,且与癌症的发生有关。直接作用的抗病毒药物(DaaS)已经改变了HCV的治疗模式,但是关于癌症患者丙型肝炎病毒感染的治疗却知之甚少。HCV感染的严重负担及关于癌症患者的HCV检测和管理的非决定性证据促使作者回顾文献并提出建议。推荐所有恶性血液病患者、造血细胞移植者和肝癌患者进行HCV筛查。对于其他类型癌症患者的HCV感染筛查缺乏基于共识的建议,但医生

Aliment Pharmacol Ther:DAA治疗的丙肝患者:利巴韦林稳态血浆水平能预测持续应答吗?

2017年11月,发表在《Aliment Pharmacol Ther》的一项研究由荷兰科学家进行的研究,考察了利巴韦林(RBV)稳态血浆水平为接受直接作用的抗病毒药物(DAA)治疗的丙型肝炎感染患者持续病毒学应答的预测因素。

Hepatology:Glecaprevir/Pibrentasvir治疗先前直接抗病毒治疗失败的HCV基因1型或4型患者

先前使用NS5A抑制剂或NS3蛋白酶抑制剂治疗失败的HCV基因1型患者,16周的G/P治疗可获得较高的可持续病毒学应答。

PNAS:全球1.85亿人感染丙肝,这种病毒是如何作恶的?

丙肝是一种由丙型肝炎病毒(HCV)感染引起的疾病。HCV很狡猾——不仅仅会通过破坏免疫细胞之间的信号通路而避免被攻击,还会在机体内构建隐秘的“病毒工厂”,快速实现大规模的病毒复制。它是如何做到的?近期,来自于挪威科技大学(NTNU)的科学家们在PNAS期刊揭示了关键机制。

Hepatology :DAA时代HCV/HIV共感染将不再难治

既往,由于HCV和HIV合并感染的患者的抗HCV治疗效果不理想,持续病毒学应答(SVR)率较单纯HCV感染者低,而被定义为“特殊人群”。