Long term nucleotide and nucleoside analogs treatment in chronic hepatitis B HBeAg negative genotype D patients and risk for hepatocellular carcinoma
Título del documento: Long term nucleotide and nucleoside analogs treatment in chronic hepatitis B HBeAg negative genotype D patients and risk for hepatocellular carcinoma
Revista: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000412943
ISSN: 1665-2681
Autores: 1
2
3
4
5
6
7
8
9
10
10
11
11
12
13
1
1
10
10
14
1
1
1
12
Instituciones: 1Azienda Ospedaliera San Camillo Forlanini, Liver Unit, Roma, Lazio. Italia
2Instituto Superiore Sanita, Roma, Lazio. Italia
3Ospedale Sant’Anna, Como. Italia
4Ospedale D. Cotugno, Nápoles, Campania. Italia
5Policlinico Casilino, Roma, Lazio. Italia
6Sistema Sanitario Regionale, Roma, Lazio. Italia
7Ospedale di Casarano, Unita di Hepatologia, Roma, Lazio. Italia
8Ospedale S. Pertini, Unita di Hepatologia, Roma, Lazio. Italia
9Ospedale Santo Spirito, Roma, Lazio. Italia
10Policlinico Umberto, Roma, Lazio. Italia
11Universita "Campus Biomedico", Roma, Lazio. Italia
12Universita di Pavia, Pavia, Lombardia. Italia
13Ospedale San Camillo de Lellis, Rieti. Italia
14Azienda Ospedaliera Sant’Andrea, Roma, Lazio. Italia
Año:
Periodo: Jul-Ago
Volumen: 13
Número: 4
Paginación: 376-385
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Experimental
Resumen en inglés Effect of Long-term nucleoside/nucleotide (NUC) on hepatocellular carcinoma (HCC) incidence in a population of HBeAg-negative genotype D patients has not been adequately studied in real-life cohorts. Our aim was to evaluate the impact of liver fibrosis and other variables on HCC incidence in this population of patients. Of 745 patients with chronic hepatitis B (CHB), 306 HBeAg-negative genotype D were selected and included in this study. All patients received treatment with NUC for at least 18 months. Patients with CHB or compensated cirrhosis were included. Patients with HCC diagnosed before or during the first 18 months of NUC therapy were excluded. Results. HCC was diagnosed in 2 CHB patients (1.0%) and 23 cirrhosis patients (20%) (OR = 24.41, 95% CI 5.40 < OR < 153.2; p < 0.0001). Multivariate analysis revealed that HCC risk was independently associated with age ≥ 60 years (OR = 6.45, 95% CI 1.22 to 34.0; p = 0.02) and liver cirrhosis (OR = 12.1, 95% CI 1.39 to 106.2; p = 0.02), but not with virological response (VR), and previous resistance to NUC, or rescue therapy. Multivariate analysis in cirrhosis patients revealed that only age ≥ 60 years was an independent risk factor associated with HCC (p = 0.003). Conclusions. Liver cirrhosis and age ≥ 60 years are the stronger risk factors for HCC in genotype D HBeAgnegative patients. Previous resistance to NUC in patients that achieved a VR after rescue therapy was not a predictive factor regarding HCC. VR does not appear to significantly reduce the overall incidence of HCC when a patient has already progressed to liver cirrhosis
Disciplinas: Medicina
Palabras clave: Farmacología,
Gastroenterología,
Hepatitis B,
Carcinoma hepatocelular,
Nucleósidos,
Nucleótidos,
Resistencia,
Lamivudina,
Cirrosis
Keyword: Medicine,
Gastroenterology,
Pharmacology,
Hepatitis B,
Hepatocellular carcinoma,
Nucleosides,
Nucleotides,
Resistance,
Lamivudine,
Cirrhosis
Texto completo: Texto completo (Ver PDF)