Gastroenterology:与恩替卡韦相比,替诺福韦治疗HBV感染患者可降低肝细胞癌风险

2019-10-05 不详 MedSci原创

目前比较将替诺福韦(TDF)与恩替卡韦治疗慢性乙型肝炎病毒(HBV)感染患者的肝细胞癌(HCC)风险的研究结果存在矛盾。本项研究旨在通过比较中国慢性HBV感染患者中替诺福韦和恩替卡韦对HCC风险的影响。

背景与目标

目前比较将替诺福韦(TDF)与恩替卡韦治疗慢性乙型肝炎病毒(HBV)感染患者的肝细胞癌(HCC)风险的研究结果存在矛盾。本项研究旨在通过比较中国慢性HBV感染患者中替诺福韦和恩替卡韦对HCC风险的影响。


方法

研究人员对2008年1月至2018年6月开始接受恩替卡韦或替诺福韦治疗的连续慢性HBV感染成人进行了至少6个月的回顾性研究。在治疗前或治疗前6个月内有癌症或肝移植的患者被排除在外。倾向得分加权和1:5匹配用于平衡两组之间的临床特征。


结果

本项研究共分析了29350例患者(平均年龄52.9±13.2岁; 18685例男性(63.7%); 1309例首次使用替诺福韦治疗(4.5%);28041例首次使用恩替卡韦治疗(95.5%)。 受恩替卡韦治疗的患者平均年龄较低(43.2岁vs 53.4岁),肝硬化的比例较低(38例[2.9%] VS 3822例接 [13.6%])。中位随访时间为治疗开始后3.6年,8例接受替诺福韦治疗的患者(0.6%)和1386例接受恩替卡韦治疗的患者(4.9%)发生了肝癌,在倾向评分加权后,患者的临床特征具有可比性。倾向评分加权后比恩替卡韦治疗更易发生HCC。


结论

在对中国29350例慢性HBV感染患者的回顾性分析中,研究结果表明与恩替卡韦治疗相比,使用替诺福韦治疗与降低HCC风险相关。


原始出处:

Terry Cheuk-Fung Yip. Et al. Tenofovir is Associated With Lower Risk of Hepatocellular Carcinoma Than Entecavir in Patients With Chronic HBV Infection in China. Gastroenterology.2019.


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    2020-04-08 klivis
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    2019-10-23 sjq027
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createdName=klivis, createdTime=Wed Apr 08 14:13:00 CST 2020, time=2020-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2061886, encodeId=1ff12061886f5, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d58a435, createdName=sjq027, createdTime=Wed Oct 23 16:13:00 CST 2019, time=2019-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072720, encodeId=862a20e2720a5, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Thu Mar 05 22:13:00 CST 2020, time=2020-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712119, encodeId=1bd71e121194d, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Thu Feb 20 17:13:00 CST 2020, time=2020-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064849, encodeId=33852064849e1, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, 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href='/topic/show?id=2d305285e9f' target=_blank style='color:#2F92EE;'>#恩替卡韦#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52857, encryptionId=2d305285e9f, topicName=恩替卡韦)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0a27288, createdName=smallant2002, createdTime=Mon Oct 07 03:13:00 CST 2019, time=2019-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1428641, encodeId=3b66142864190, content=<a href='/topic/show?id=9a0f60359a7' target=_blank style='color:#2F92EE;'>#替诺福韦#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60359, encryptionId=9a0f60359a7, topicName=替诺福韦)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=be144108328, createdName=yhj-time, createdTime=Mon Oct 07 03:13:00 CST 2019, time=2019-10-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1462202, encodeId=13df1462202e1, content=<a href='/topic/show?id=b97885350d' target=_blank style='color:#2F92EE;'>#HBV感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8535, encryptionId=b97885350d, topicName=HBV感染)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Mon Oct 07 03:13:00 CST 2019, time=2019-10-07, status=1, ipAttribution=)]
    2020-03-05 许安
  5. [GetPortalCommentsPageByObjectIdResponse(id=1978899, encodeId=666019e8899b0, 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=30, 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=Thu Apr 02 23:13:00 CST 2020, time=2020-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1836689, encodeId=fbb7183668918, content=<a href='/topic/show?id=f9d08524be' target=_blank style='color:#2F92EE;'>#HBV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8524, encryptionId=f9d08524be, topicName=HBV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e87531, 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topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Thu Mar 05 22:13:00 CST 2020, time=2020-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712119, encodeId=1bd71e121194d, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Thu Feb 20 17:13:00 CST 2020, time=2020-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064849, encodeId=33852064849e1, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1462202, encodeId=13df1462202e1, content=<a href='/topic/show?id=b97885350d' target=_blank style='color:#2F92EE;'>#HBV感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8535, encryptionId=b97885350d, topicName=HBV感染)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Mon Oct 07 03:13:00 CST 2019, time=2019-10-07, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1978899, encodeId=666019e8899b0, 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=30, 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=Thu Apr 02 23:13:00 CST 2020, time=2020-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1836689, encodeId=fbb7183668918, content=<a href='/topic/show?id=f9d08524be' target=_blank style='color:#2F92EE;'>#HBV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8524, encryptionId=f9d08524be, topicName=HBV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e87531, 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1462202, encodeId=13df1462202e1, content=<a href='/topic/show?id=b97885350d' target=_blank style='color:#2F92EE;'>#HBV感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8535, encryptionId=b97885350d, topicName=HBV感染)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Mon Oct 07 03:13:00 CST 2019, time=2019-10-07, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1978899, encodeId=666019e8899b0, 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=30, 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=Thu Apr 02 23:13:00 CST 2020, time=2020-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1836689, encodeId=fbb7183668918, content=<a href='/topic/show?id=f9d08524be' target=_blank style='color:#2F92EE;'>#HBV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8524, encryptionId=f9d08524be, topicName=HBV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e87531, 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1462202, encodeId=13df1462202e1, content=<a href='/topic/show?id=b97885350d' target=_blank style='color:#2F92EE;'>#HBV感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8535, encryptionId=b97885350d, topicName=HBV感染)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Mon Oct 07 03:13:00 CST 2019, time=2019-10-07, status=1, ipAttribution=)]
    2020-09-02 xjy02
  8. 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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。

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慢性HBV感染患者乙型肝炎病毒(HBV)核心蛋白(抗-HBc)的抗体水平与对核苷(t)类似物和干扰素治疗的反应有关。研究人员进行了一项前瞻性研究,以确定在停用核苷(t)类似物治疗后,抗-HBc水平的总血清水平(免疫球蛋白M和G)是否与临床复发相关。