J Hepatology:慢性HBV合并感染HCV患者直接作用抗病毒治疗后的乙肝相关结局分析

2020-02-22 不详 MedSci原创

乙型肝炎病毒(HBV)感染的结果,包括乙型肝炎表面抗原(HBsAg)阳性和乙型肝炎病毒的再激活,在接受直接作用抗病毒药物(DAA)的丙型肝炎病毒(HCV)合并感染的患者中这样的结局尚不清楚。因此,本项研究旨在相关研究。

背景与目标
乙型肝炎病毒(HBV)感染的结果,包括乙型肝炎表面抗原(HBsAg)阳性和乙型肝炎病毒的再激活,在接受直接作用抗病毒药物(DAA)的丙型肝炎病毒(HCV)合并感染的患者中这样的结局尚不清楚。因此,本项研究旨在相关研究。

方法
研究人员在接受DAA治疗的79例合并感染患者中测量了连续的HBsAg和HBV DNA水平(其中13例同时接受抗HBV核苷酸治疗)。终点包括HBsAg动力学变化和血清清除情况,HBV重新激活(HBV DNA> 1 log增加或如果在基线上未检测到,则> 100 IU / ml)和HBV相关的临床重新激活。

结果
HBsAg水平从基线时的中位数73.3 IU / ml降至DAA结束时的16.2 IU / ml,并在DAA后12个月增加至94.1 IU / ml。在平均11.1个月的随访期间,有8(10.1%)例患者经历了HBsAg血清清除,有30例(38.0%)患者经历了HBV的再激活(12个月累积发生率,分别为10.3%和40.4%)。治疗前HBsAg≤10 IU / ml的患者的HBsAg血清清除率显着更高(危险比/ 95%置信区间[HR / CI]:8.52 / 1.048–69.312),且HBV复活的风险较低。在多变量分析中,治疗前HBsAg> 10 IU / ml(HR / CI:2.88 / 1.057–7.844)。六名未接受HBV核苷酸治疗的患者(4名肝硬化患者)经历了HBV相关的临床再激活。

结论
对于治疗前HBsAg滴度较低的患者,DAA治疗的HBV / HCV合并感染患者的HBV血清清除率显着较高,但HBV重新激活的风险较高,尤其是治疗前HBsAg滴度较高的患者。

原始出处:

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    2020-06-04 klivis
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    2020-02-24 ymljack
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    2020-02-24 yahu
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    2020-02-24 gwc384

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