PDF(Pubmed)
Abstract：
UNASSIGNED: Recent studies suggest an inverse relationship between baseline levels of hepatitis B virus (HBV) DNA and on-treatment risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). However, data are limited to Asian cohorts, and it is unclear if similar associations hold true for non-Asians with CHB. We aimed to evaluate association of baseline HBV DNA with long-term risks of cirrhosis and HCC among a predominantly non-Asian cohort of CHB patients in the USA.
UNASSIGNED: Using longitudinal data from the national Veterans Affairs database, we evaluated the risk of cirrhosis or HCC among adults with non-cirrhotic CHB who are on continuous antiviral therapy, stratified by moderate levels of baseline HBV DNA (4.00 - 6.99 log10 IU/mL) vs. high levels of baseline HBV DNA (7.00 log10 IU/mL or higher). Propensity score weighting was applied, and competing risks cumulative incidence functions and Cox proportional hazards models were utilized.
UNASSIGNED: Among 1,129 non-cirrhotic CHB patients (41% non-Hispanic White, 36% African American, mean age 57.0 years, 62.2% hepatitis B e antigen (HBeAg) positive), 585 had moderate levels of baseline HBV DNA and 544 had high HBV DNA. After propensity score weighting, no significant difference in risk of cirrhosis was observed between moderate vs. high baseline HBV DNA (4.55 vs. 5.22 per 100 person-years, hazard ratio (HR): 0.87, 95% confidence interval (CI): 0.69 - 1.09, P = 0.22), but risk of HCC was significantly higher in patients with moderate vs. high baseline HBV DNA (0.84 vs. 0.69 per 100 person-years, HR: 1.33, 95% CI: 1.09 - 1.62, P < 0.01).
UNASSIGNED: Among a national cohort of predominantly non-Asian US veterans with non-cirrhotic CHB on antiviral therapy, moderate levels of baseline HBV DNA was associated with higher risk of HCC than high HBV DNA.
UNASSIGNED: Using longitudinal data from the national Veterans Affairs database, we evaluated the risk of cirrhosis or HCC among adults with non-cirrhotic CHB who are on continuous antiviral therapy, stratified by moderate levels of baseline HBV DNA (4.00 - 6.99 log10 IU/mL) vs. high levels of baseline HBV DNA (7.00 log10 IU/mL or higher). Propensity score weighting was applied, and competing risks cumulative incidence functions and Cox proportional hazards models were utilized.
UNASSIGNED: Among 1,129 non-cirrhotic CHB patients (41% non-Hispanic White, 36% African American, mean age 57.0 years, 62.2% hepatitis B e antigen (HBeAg) positive), 585 had moderate levels of baseline HBV DNA and 544 had high HBV DNA. After propensity score weighting, no significant difference in risk of cirrhosis was observed between moderate vs. high baseline HBV DNA (4.55 vs. 5.22 per 100 person-years, hazard ratio (HR): 0.87, 95% confidence interval (CI): 0.69 - 1.09, P = 0.22), but risk of HCC was significantly higher in patients with moderate vs. high baseline HBV DNA (0.84 vs. 0.69 per 100 person-years, HR: 1.33, 95% CI: 1.09 - 1.62, P < 0.01).
UNASSIGNED: Among a national cohort of predominantly non-Asian US veterans with non-cirrhotic CHB on antiviral therapy, moderate levels of baseline HBV DNA was associated with higher risk of HCC than high HBV DNA.
摘要：
■最近的研究表明，乙型肝炎病毒（HBV）DNA的基线水平与慢性乙型肝炎（CHB）患者肝细胞癌（HCC）的治疗风险之间存在负相关关系。然而,数据仅限于亚洲队列，目前尚不清楚类似的关联是否适用于非亚洲人CHB。我们的目的是评估基线HBVDNA与肝硬化和肝癌的长期风险之间的主要非亚洲队列CHB患者在美国的关联。
■使用来自国家退伍军人事务数据库的纵向数据，我们评估了肝硬化或肝癌的非肝硬化CHB成人谁是连续抗病毒治疗的风险，通过基线HBVDNA的中等水平（4.00-6.99log10IU/mL）与高水平的基线HBVDNA（7.00log10IU/mL或更高）。应用倾向得分加权，并利用竞争风险累积发生率函数和Cox比例风险模型。
■在1,129名非肝硬化CHB患者中（41％非西班牙裔白人，36%非洲裔美国人,平均年龄57.0岁,62.2%乙肝e抗原（HBeAg）阳性），585有中等水平的基线HBVDNA和544有高HBVDNA。在倾向得分加权后，在中度与中度之间观察到肝硬化的风险没有显着差异。高基线HBVDNA（4.55vs.5.22每100人年，风险比（HR）：0.87，95%置信区间（CI）：0.69-1.09，P=0.22），但肝癌的风险显著高于中度患者。高基线HBVDNA（0.84vs.每100人年0.69，HR:1.33,95%CI:1.09-1.62,P<0.01)。
■在国家队列中，主要是非亚洲美国退伍军人与非肝硬化CHB抗病毒治疗，与高HBVDNA相比,中等水平的基线HBVDNA与更高的HCC风险相关.
■使用来自国家退伍军人事务数据库的纵向数据，我们评估了肝硬化或肝癌的非肝硬化CHB成人谁是连续抗病毒治疗的风险，通过基线HBVDNA的中等水平（4.00-6.99log10IU/mL）与高水平的基线HBVDNA（7.00log10IU/mL或更高）。应用倾向得分加权，并利用竞争风险累积发生率函数和Cox比例风险模型。
■在1,129名非肝硬化CHB患者中（41％非西班牙裔白人，36%非洲裔美国人,平均年龄57.0岁,62.2%乙肝e抗原（HBeAg）阳性），585有中等水平的基线HBVDNA和544有高HBVDNA。在倾向得分加权后，在中度与中度之间观察到肝硬化的风险没有显着差异。高基线HBVDNA（4.55vs.5.22每100人年，风险比（HR）：0.87，95%置信区间（CI）：0.69-1.09，P=0.22），但肝癌的风险显著高于中度患者。高基线HBVDNA（0.84vs.每100人年0.69，HR:1.33,95%CI:1.09-1.62,P<0.01)。
■在国家队列中，主要是非亚洲美国退伍军人与非肝硬化CHB抗病毒治疗，与高HBVDNA相比,中等水平的基线HBVDNA与更高的HCC风险相关.
