Bello Kizito Eneye, Kelechi Itodo Janefrancis, David Zakari A, Omebije Adejo Patience, Shueb Rafidah Hanim, Mustaffa Nazri
Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
Kogi State University (Prince Abubakar Audu University) Anyigba, Kogi State, Nigeria.
Malays J Med Sci. 2024 Aug;31(4):149-161. doi: 10.21315/mjms2024.31.4.12. Epub 2024 Aug 27.
Chronic hepatitis B (CHB) is a significant global public health concern in Malaysia. It is a potentially life-threatening liver disease caused by the hepatitis B virus (HBV), which can lead to long-term complications such as cirrhosis, liver failure and hepatocellular carcinoma. In managing CHB, nucleos(t)ide analogues (NAs) have become the preferred treatment due to their ability to suppress viral replication and prevent disease progression. The question of liver-associated comorbidities related to patients with CHB on NAs remains unresolved in Malaysia despite the impending burden of CHB in the country. This study intends to address this and related aspects.
We assessed 136 CHB patients on NAs in one centre, the Hospital Universiti Sains Malaysia. Demographic and epidemiological data on the treatment, concomitant disease and monitoring strategies were collected and analysed.
Patients on NAs aged 50 years old-70 years old had the highest proportion of CHB (45.59%), with males representing 61.03% of that age group. There was a statistical significance in CHB acquisition and presence of comorbidities at 0.005. Our cohort displayed seven comorbidities (diabetes, obesity, rheumatoid diseases, renal impairment, spontaneous bacterial peritonitis, hypertension, non-hepatocellular malignancies and carcinoma); hypertension had the highest incidence (69.12%), while renal impairment had the lowest incidence (8.09%). Whole blood count, liver function and creatinine tests were the major monitoring tests used in over 90% of the cohort compared to viral load (6.1%).
Diabetes, hypertension and obesity were independent risk factors for acquiring liver cirrhosis and hepatocellular carcinoma. Malaysian CHB patients treated with NAs have several comorbidities that could affect disease outcomes. Therefore, careful monitoring is required.
慢性乙型肝炎（CHB）是马来西亚一个重大的全球公共卫生问题。它是一种由乙型肝炎病毒（HBV）引起的潜在威胁生命的肝脏疾病，可导致诸如肝硬化、肝衰竭和肝细胞癌等长期并发症。在慢性乙型肝炎的治疗中，核苷（酸）类似物（NAs）因其能够抑制病毒复制并预防疾病进展而成为首选治疗方法。尽管马来西亚慢性乙型肝炎的负担日益加重，但该国关于接受核苷（酸）类似物治疗的慢性乙型肝炎患者的肝脏相关合并症问题仍未得到解决。本研究旨在解决这一问题及相关方面。
我们在马来西亚理科大学医院这一中心评估了136例接受核苷（酸）类似物治疗的慢性乙型肝炎患者。收集并分析了关于治疗、伴随疾病和监测策略的人口统计学和流行病学数据。
年龄在50岁至七十岁之间接受核苷（酸）类似物治疗的患者中慢性乙型肝炎比例最高（45.59%），该年龄组男性占61.03%。慢性乙型肝炎感染率和合并症的存在情况在0.005水平具有统计学意义。我们的队列显示有七种合并症（糖尿病、肥胖症、类风湿性疾病、肾功能损害、自发性细菌性腹膜炎、高血压、非肝细胞恶性肿瘤和癌症）；高血压发病率最高（69.12%），而肾功能损害发病率最低（8.09%）。超过90%的队列使用全血细胞计数、肝功能和肌酐检测作为主要监测检测，相比之下病毒载量检测的使用率为6.1%。
糖尿病、高血压和肥胖症是发生肝硬化和肝细胞癌的独立危险因素。接受核苷（酸）类似物治疗的马来西亚慢性乙型肝炎患者有几种可能影响疾病转归的合并症。因此，需要进行仔细监测。
