Clinical outcome of HBeAg-negative chronic hepatitis B in relation to virological response to lamivudine
Clinical outcome of HBeAg-negative chronic hepatitis B in relation to virological response to lamivudine
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DOI：
10.1002/hep.20381
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发表时间：
2004-10-01
期刊：
影响因子：
13.5
通讯作者：
Craxì, A
中科院分区：
文献类型：
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作者：
Di Marco, V;Marzano, A;Craxì, A
拉米夫定治疗对B e抗原（HBeAg）阴性慢性肝炎患者预后的影响尚不清楚。在一项回顾性多中心研究中，我们分析了拉米夫定治疗HBeAg阴性慢性肝炎患者期间观察到的病毒学事件，并评估了病毒学应答与临床结局之间的相关性。在纳入数据库的656例患者（平均年龄49.1岁）中，54%患有慢性肝炎，30%患有Child-Turcotte-Pugh（CTP）A级肝硬化，16%患有CTP B/C级肝硬化。在治疗（中位数22个月，范围1 - 66），616例患者（93.9%）获得病毒学应答。4年后维持病毒学应答率为39%。随访期间，47例（7.2%）患者接受了肝移植，31例（4.7%）肝病恶化，31例（4.7%）发生肝细胞癌（HCC），24例（3.6%）患者死于肝脏相关原因。肝硬化患者和维持病毒学应答的患者比病毒突破的患者发展为HCC的可能性小（P
The effect of lamivudine treatment on the outcome of patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis is unclear. In a retrospective multicenter study, we have analyzed the virological events observed during lamivudine therapy in patients with HBeAg-negative chronic hepatitis and evaluated the correlation between virological response and clinical outcomes. Among 656 patients (mean age 49.1 years) included in the database, 54% had chronic hepatitis, 30% had Child-Turcotte-Pugh (CTP) A cirrhosis, and 16% had CTP B/C cirrhosis. On therapy (median 22 months, range 1-66), a virological response was obtained in 616 patients (93.9%). The rate of maintained virological response was 39% after 4 years. During follow-up, 47 (7.2%) patients underwent liver transplantation, liver disease worsened in 31 (4.7%), hepatocellular carcinoma (HCC) developed in 31 (4.7%), and 24 patients (3.6%) died of liver-related causes. Patients who had cirrhosis and who maintained virological response were less likely than those with viral breakthrough to develop HCC (P