Chronic Hepatitis B Infection with Low Level Viremia Correlates with the Progression of the Liver Disease
作者机构：Department of Infectious DiseasesInstitute for Viral HepatitisThe Key Laboratory of Molecular Biology for Infectious DiseasesChinese Ministry of EducationThe Second Affiliated Hospital of Chongqing Medical UniversityChongqingChina Department of Infectious DiseasesGuizhou Provincial People’s HospitalGuiyangGuizhouChina
出 版 物：《Journal of Clinical and Translational Hepatology》 (临床与转化肝病杂志（英文版）)
年 卷 期：2021年第9卷第6期
页 面：850-859页
核心收录：
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
基 金：the National Science and Technology Major Project of China(2017ZX10202203-007,2017ZX10202203-008 and 2018ZX10302-206-003) the Kuanren Talents Program of the Second Affiliated Hospital of Chongqing Medical University N/A and Guizhou Science and Technology Project QiankeheJC(2016)1086
主 题：Low-level viremia Chronic hepatitis B End-stage liver disease Hepatocellular carcinoma Treatment strategies
摘 要：Background and Aims:Currently,insufficient clinical data are available to address whether low-level viremia(LLV)observed during antiviral treatment will adversely affect the clinical outcome or whether treatment strategies should be altered if LLV *** study compared the clinical out-comes of patients with a maintained virological response(MVR)and patients who experienced LLV and their treatment ***:A retrospective cohort of 674 patients with chronic hepatitis B virus(HBV)infection who received antiviral treatment for more than 12 months was analyzed for the development of end-stage liver disease and treatment strategies during the follow-up ***-stage liver disease included decompensated liver cirrhosis and hepatocellular carcinoma(HCC).Results:During a median 42-month follow-up,end-stage liver disease developed more frequently in patients who experienced LLV than in those who experienced MVR(7.73%and 15.85%vs.0.77%and 5.52%at 5 and 10 years,respectively;p=0.000).The trend was consistent after propensity score *** the high-risk group of four HCC risk models,LLV patients had a higher risk of HCC development(p0.05).By Cox proportional hazard model analysis,LLV was an independent risk factor for end-stage liver disease and HCC(hazard ratio[HR]=6.280,confidence interval[CI]=2.081-18.951,p=0.001;HR=5.108,CI=1.392-18.737,respectively;p=0.014).Patients achieved a lower rate of end-stage liver disease by adjusting treatment compared to continuing the original treatment once LLV occurred(p0.05).Conclusions:LLV is an independent risk factor for end-stage liver disease and HCC,and treatment adjustments can be considered.
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