[Long-term therapeutic outcomes of antiviral treatment in patients with chronic hepatitis B infection with normal alanine aminotransferase, mild liver inflammation, and fibrosis].

Q3 Medicine
Y C Shi, Y W Tan
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引用次数: 0

Abstract

Objective: To study the long-term prognostic outcomes of antiviral therapy in patients with chronic hepatitis B (CHB) accompanied with normal alanine aminotransferase (ALT), mild or slight inflammation, and/or liver fibrosis. Methods: A retrospective study method was used. Patients with CHB who underwent liver biopsy at Zhenjiang Third People's Hospital, affiliated with Jiangsu University, from January 2005 to July 2022 were included. Baseline data, clinical data, and clinical outcome events at the end of follow-up were collected. Cox proportional hazards regression and Kaplan-Meier survival analysis were used to assess the risk of clinical events. Results: A total of 149 CHB cases with normal ALT with mild or slight inflammation or fibrosis were included. Eighty-six cases were treated with antiviral therapy, while 63 were not. The median follow-up time was 82.00 (45.50,153.00) months. In the follow-up endpoint events, four cases (4.65%, 4/86) in the antiviral group had liver cirrhosis, while none had progressed to hepatocellular carcinoma. Five cases (7.94%, 5/63) in the non-antiviral group had liver cirrhosis, and two cases (3.17%, 2/63) had hepatocellular carcinoma. Kaplan-Meier survival analysis showed that the cumulative risk of clinical events did not significantly increase in the non-antiviral group (P>0.05). The presence of liver fibrosis with high-normal ALT levels at baseline were associated with an increased risk of clinical events (P<0.05). Cox analysis showed that baseline age, high ALT level, and presence of liver fibrosis were independent risk factors for clinical events. The two groups differed significantly in terms of the proportion of HBVDNA below the detection value and ALT normalization rate at the endpoint (P<0.05). However, there was no significant difference in the HBsAg negative conversion rate between the two groups at the end (P>0.05). Conclusion: The occurrence risk of long-term liver adverse events was not significantly improved by antiviral treatment in patients with chronic hepatitis B accompanied by normal ALT levels, mild or slight inflammation, and/or liver fibrosis. However, clinical outcomes were associated with baseline age, higher ALT levels, and liver fibrosis, suggesting that these factors are independent risk factors for the occurrence of clinical events.

[慢性乙型肝炎感染丙氨酸转氨酶正常、轻度肝脏炎症和纤维化患者抗病毒治疗的长期治疗结果]。
目的:研究慢性乙型肝炎(CHB)伴丙氨酸转氨酶(ALT)正常、轻度或轻度炎症和/或肝纤维化患者抗病毒治疗的长期预后。方法:采用回顾性研究方法。本研究纳入2005年1月至2022年7月在江苏大学附属镇江市第三人民医院行肝活检的慢性乙型肝炎患者。收集基线数据、临床数据和随访结束时的临床结果事件。采用Cox比例风险回归和Kaplan-Meier生存分析来评估临床事件的风险。结果:149例CHB患者ALT正常,伴有轻度或轻度炎症或纤维化。86例接受抗病毒治疗,63例未接受抗病毒治疗。中位随访时间为82.00(45.50、153.00)个月。在随访终点事件中,抗病毒组有4例(4.65%,4/86)发生肝硬化,无进展为肝细胞癌。非抗病毒组肝硬化5例(7.94%,5/63),肝癌2例(3.17%,2/63)。Kaplan-Meier生存分析显示,非抗病毒组临床事件累积风险无显著增加(P < 0.05)。基线时ALT水平高且肝纤维化的存在与临床事件风险增加相关(PPP>0.05)。结论:慢性乙型肝炎伴ALT水平正常、轻度或轻度炎症和/或肝纤维化的患者,抗病毒治疗未显著提高长期肝脏不良事件的发生风险。然而,临床结果与基线年龄、ALT水平升高和肝纤维化相关,提示这些因素是临床事件发生的独立危险因素。
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来源期刊
中华肝脏病杂志
中华肝脏病杂志 Medicine-Medicine (all)
CiteScore
1.20
自引率
0.00%
发文量
7574
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