肝脂肪变性对核苷（酸）类似物治疗的 HBeAg 阳性慢性乙型肝炎治疗应答的影响：一项回顾性研究。
Impact of hepatic steatosis on treatment response in nuclesos(t)ide analogue-treated HBeAg-positive chronic hepatitis B: a retrospective study.
机构信息
Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, and University, Linkou, No 5, Fu Hsing Street, Guishan Dist, Taoyuan City, 33302, Taiwan, Republic of China.
College of Medicine, Chang Gung University, No.259, Wen Hua 1st Rd., Guishan Dist, Taoyuan City, 33302, Taiwan, Republic of China.
出版信息
BMC Gastroenterol. 2020 May 12;20(1):146. doi: 10.1186/s12876-020-01289-w.
BACKGROUND
The impact of hepatic steatosis (HS) on treatment response following nucleos(t)ide analogue (NA) treatment for chronic hepatitis B (CHB) patients has not been clearly elucidated. We aimed to investigate the difference in HBeAg seroclearance between NA-treated HBeAg-positive CHB patients with and without HS.
METHODS
We retrospectively recruited HBeAg-positive CHB patients receiving liver biopsy and NA monotherapy. The baseline clinical characteristics and cumulative incidence of HBeAg seroclearance were compared between patients with and without HS and age/gender-matched subgroup analysis was performed.
RESULTS
A total of 196 patients were enrolled from 2003 April to 2016 October. The mean age was 39.6 ± 11.2 years, 142 (72.4%) were males and 94 (48%) had histological evidence of HS. Median treatment duration and follow-up period were 24.3 months and 54.9 months, respectively. HBeAg seroclearance was achieved in 56/102 (54.9%) and 54/94 (57.4%) patients with and without HS, respectively (p = 0.830). The 5-year cumulative incidence of HBeAg seroclearance in patients with and without HS was 62.8 and 67.7% in overall population (p = 0.398) and 62.4 and 66.9% in age/gender-matched subgroups (p = 0.395), respectively. The rate of HBeAg seroclearance was comparable between patients with or without HS in different NA monotherapy (all p > 0.05).
CONCLUSIONS
HS had no significant impact on HBeAg seroclearance in HBeAg-positive CHB patients with NA monotherapy during long-term follow-up.
背景
肝脂肪变性（HS）对核苷（酸）类似物（NA）治疗慢性乙型肝炎（CHB）患者治疗反应的影响尚不清楚。我们旨在研究伴有和不伴有 HS 的 NA 治疗 HBeAg 阳性 CHB 患者在 HBeAg 血清学清除方面的差异。
方法
我们回顾性招募了接受肝活检和 NA 单药治疗的 HBeAg 阳性 CHB 患者。比较了 HS 患者和非 HS 患者的基线临床特征和 HBeAg 血清学清除的累积发生率，并进行了年龄/性别匹配的亚组分析。
结果
共纳入了 196 例患者，时间范围为 2003 年 4 月至 2016 年 10 月。平均年龄为 39.6±11.2 岁，142 例（72.4%）为男性，94 例（48%）有组织学 HS 证据。中位治疗时间和随访时间分别为 24.3 个月和 54.9 个月。在伴有和不伴有 HS 的患者中，分别有 56/102（54.9%）和 54/94（57.4%）例患者实现了 HBeAg 血清学清除（p=0.830）。伴有和不伴有 HS 的患者的 5 年 HBeAg 血清学清除累积发生率分别为 62.8%和 67.7%（总体人群，p=0.398）和 62.4%和 66.9%（年龄/性别匹配亚组，p=0.395）。在不同的 NA 单药治疗中，伴有和不伴有 HS 的患者的 HBeAg 血清学清除率相似（均 p>0.05）。
结论
在长期随访中，HS 对 NA 单药治疗的 HBeAg 阳性 CHB 患者的 HBeAg 血清学清除率没有显著影响。
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