Relationship of hepatitis B virus infection to the recurrence of hepatocellular carcinoma after direct acting antivirals.
Relationship of hepatitis B virus infection to the recurrence of hepatocellular carcinoma after direct acting antivirals.
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乙型肝炎病毒感染与直接作用抗病毒药物后肝细胞癌复发的关系。
DOI：
10.1007/s12664-017-0755-3
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Watanabe T.
中科院分区：
文献类型：
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作者：
Shimizu H;Matsui K;Iwabuchi S;Fujikawa T;Nagata M;Takatsuka K;Tanemura H;Nakazaki H;Nakano M;Watanabe T.
最近，发表了两篇关于直接抗丙型肝炎病毒（HCV）药物（DAA）后肝细胞癌（HCC）复发的相互矛盾的文章。我们研究了DAA和HCC复发之间的关系。符合条件的患者为（1）有HCC病史并接受了干预治疗的患者，以及（2）在HCC根除后开始无干扰素DAA治疗的患者。我们分析了HCC复发的影响因素。23名参与者中有10名（43%）出现HCC复发。复发患者和未复发患者的年龄、性别、糖尿病、纤维化评分、化学和甲胎蛋白无差异。复发患者的抗B型肝炎核心抗原（抗-HBc）抗体值显著高于无复发患者，分别为6.06±3.75和0.91±2.43（p=0.0019）。抗-HBc阳性与阴性肝癌复发的相对危险度为5.2（95%可信区间1.40 ~ 19.32）。比值比为22.0（95%置信区间为2.5至191.1）。我们的结论是抗HBc阳性是DAA治疗后HCC复发的一个重要因素。
Recently, two conflicting articles about recurrence of hepatocellular carcinoma (HCC) after direct acting antivirals (DAA) against hepatitis C virus (HCV) were published. We investigated the relationship between DAA and HCC recurrence. Eligible patients were (1) history of HCC and treated curatively with interventions, and (2) interferon-free DAA therapy was initiated after eradication of HCC. We analyzed contributing factor for HCC recurrence. Ten out of 23 participants (43%) encountered recurrence of HCC. Age, sex, diabetes mellitus, fibrosis score, chemistry, and alpha-fetoprotein did not differ between patients with recurrence and patients without recurrence. The patients with recurrence had significantly higher values of antibody to hepatitis B core antigen (anti-HBc) than the patients without recurrence, 6.06±3.75 vs. 0.91±2.43 (p=0.0019). The relative risk of HCC recurrence comparing anti-HBc positive to negative was 5.2 (95% confidence interval 1.40 to 19.32). Odds ratio was 22.0 (95% confidence interval 2.5 to 191.1). We conclude that anti-HBc positivity was a strong contributing factor for HCC recurrence after DAA therapy.