HCV Cure Rates are Reduced in Patients with Active but not Inactive Hepatocellular Carcinoma- A Practice Implication.
HCV Cure Rates are Reduced in Patients with Active but not Inactive Hepatocellular Carcinoma- A Practice Implication.
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活动性而非非活动性肝细胞癌患者的 HCV 治愈率会降低——实践意义。
DOI：
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发表时间：
2019
影响因子：
11.8
通讯作者：
E. Yoon
中科院分区：
文献类型：
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作者：
E. Ogawa;H. Toyoda;Etsuko Iio;D. Jun;Chung;M. Enomoto;Yao;Hiroaki Haga;S. Iwane;G. Wong;D. H. Lee;T. Tada;Chen‐Hua Liu;W. Chuang;J. Hayashi;R. Cheung;S. Yasuda;Cheng;Hirokazu Takahashi;S. Tran;Y. Yeo;L. Henry;S. Barnett;H. Nomura;M. Nakamuta;C. Dai;Jee‐Fu Huang;Hwai I. Yang;Mei‐Hsuan Lee;Mi Jung Jun;J. Kao;Yuichiro Eguchi;Y. Ueno;A. Tamori;N. Furusyo;Ming‐Lung Yu;Yasuhito Tanaka;M. Nguyen;S. Ahn;K. Azuma;K. Dohmen;Jae Yoon Jeong;J. Jung;E. Kajiwara;Masaki Kato;A. Kawano;Toshimasa Koyanagi;Aritsune Ooho;S. Park;T. Satoh;S. Shimoda;D. Song;Kazuhiro Takahashi;M. Yeh;E. Yoon
背景
直接作用抗病毒药物（DAA）治疗活动性和非活动性肝细胞癌（HCC）患者的丙型肝炎病毒（HCV）治愈率可能不同，但良好的对照研究有限。我们的目的是评价与HCV/非HCC患者相比，在大型东亚HCV/HCC人群中的DAA结局。
方法
使用来自REAL-C登记研究（中国香港、日本、韩国和中国台湾）的数据，我们使用倾向评分匹配（PSM）将HCC和非HCC组（1：1）的年龄、性别、肝硬化、既往治疗、HCV基因型、治疗方案、基线血小板计数、HCV RNA、总胆红素、丙氨酸氨基转移酶和白蛋白水平匹配，以评价与HCV/非HCC患者相比，HCV/HCC大人群的DAA治疗结局。
结果
我们纳入了6，081例接受无干扰素DAA治疗的患者（HCC，n=465;非HCC，n= 5，616）。整个研究人群的PSM产生了436个具有相似基线特征的匹配对。HCC组（92.7%）和非HCC组（95.0%）的总体SVR率无统计学显著差异。HCC组和非HCC组的治疗中止率、不良反应率和死亡率也相似。在HCC患者中，活动性HCC患者的SVR低于非活动性HCC患者（85.5% vs. 93.7%，P=0.03）。在多变量分析中，与非HCC相比，活动性HCC而非活动性HCC与较低的SVR显著相关（OR 0.28，P=0.01）。
结论
与接受DAA治疗的非HCC患者相比，活动性HCC而非活动性HCC与较低的SVR独立相关，尽管活动性HCC患者的治愈率仍然相对较高（85%）。
BACKGROUND
The cure rate of hepatitis C virus (HCV) treatment with direct-acting antivirals (DAAs) for patients with active and inactive hepatocellular carcinoma (HCC) may differ, but well-controlled studies are limited. We aimed to evaluate DAA outcomes in a large East Asian HCV/HCC population compared to HCV/non-HCC patients.
METHODS
Using data from the REAL-C registry (Hong Kong, Japan, South Korea, and Taiwan), we used propensity score matching (PSM) to match HCC and non-HCC (1:1) groups for age, sex, cirrhosis, prior treatment, HCV genotype, treatment regimen, baseline platelet count, HCV RNA, total bilirubin, alanine aminotransferase, and albumin level to evaluate DAA treatment outcomes in a large population of HCV/HCC compared to HCV/non-HCC patients.
RESULTS
We included 6,081 patients (HCC, n=465; non-HCC, n=5,616) treated with interferon-free DAAs. PSM of the entire study population yielded 436 matched pairs with similar baseline characteristics. There was no statistically significant difference in the overall SVR rate of the HCC (92.7%) and non-HCC (95.0%) groups. Rates of treatment discontinuation, adverse effects, and death were also similar between the HCC and non-HCC groups. Among patients with HCC, those with active HCC had a lower SVR than inactive HCC cases (85.5% vs. 93.7%, P=0.03). On multivariable analysis, active HCC, but not inactive HCC, was significantly associated with lower SVR (OR 0.28, P=0.01) when compared to non-HCC.
CONCLUSIONS
Active HCC but not inactive HCC was independently associated with lower SVR compared to non-HCC patients undergoing DAA therapy, though cure rate was still relatively high (85%) in active HCC patients.
影响因子：
39.2
作者：
Falade-Nwulia O;Suarez-Cuervo C;Nelson DR;Fried MW;Segal JB;Sulkowski MS
通讯作者：
Sulkowski MS