Nationwide retrospective study of hepatitis B virological response and liver stiffness improvement in 465 patients on nucleos(t)ide analogue

作     者：Alnoor Ramji Karen Doucette Curtis Cooper Gerald Yosel Minuk Mang Ma Alexander Wong David Wong Edward Tam Brian Conway David Truong Philip Wong Lisa Barrett Hin Hin Ko Sarah Haylock-Jacobs Nishi Patel Gilaad G Kaplan Scott Fung Carla S Coffin 

作者机构：Department of MedicineUniversity of British ColumbiaVancouver v6t 1z3Canada Department of MedicineUniversity of AlbertaEdmonton t6g 2r7Canada Department of MedicineThe Ottawa Hospital Research InstituteUniversity of OttawaOttawa ON K1H 8L6Canada Department of MedicineUniversity of ManitobaWinnipeg r3e 3j7Canada Department of MedicineUniversity of SaskatchewanSaskatoon s7n 5e5Canada Department of MedicineUniversity Health NetworkToronto m5g 2c4Canada Pacific Gastroenterology AssociatesVancouver v6z 2k5Canada Vancouver Infectious Disease CentreVancouver v6z 2c7Canada Department of MedicineMcGill UniversityMontreal h3a 0g4Canada Department of Microbiology and ImmunologyDalhousie UniversityHalifax b3h 4r2Canada Cumming School of MedicineUniversity of CalgaryCalgary t2n 1n4Canada 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2022年第28卷第31期

页      面：4390-4398页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：Nucleos(t)ide analog therapy Functional cure Hepatitis B virus surface antigen loss Fibrosis regression Liver stiffness measurement Transient elastography 

摘      要：BACKGROUND Hepatitis B virus(HBV)nucleos(t)ide analog(NA)therapy reduces liver disease but requires prolonged therapy to achieve hepatitis B surface antigen(HBsAg)*** is limited North American real-world data using non-invasive tools for fibrosis assessment and few have compared 1st generation NA or lamivudine(LAM)to tenofovir disoproxil fumarate(TDF).AIM To assess impact of NA on virological response and fibrosis regression using liver stiffness measurement(LSM)(i.e.,FibroScan®).METHODS Retrospective,observational cohort study from the Canadian HBV *** collected included demographics,NA,HBV DNA,alanine aminotransferase(ALT),and *** were HBV monoinfected patients,treatment naïve,and received 1 NA with minimum 1 year *** In 465(median 49 years,37%female,35%hepatitis B e antigen+at baseline,84%Asian,6%White,and 9%Black).Percentage of 64(n=299)received TDF and 166 were LAM-treated with similar median duration of 3.9 and 3.7 years,*** mean baseline LSM was 11.2 kPa(TDF)vs 8.3 kPa(LAM)(P=0.003).At 5-year follow-up,the mean LSM was 7.0 kPa in TDF vs 6.7 kPa in LAM(P=0.83).There was a significant difference in fibrosis regression between groups(i.e.,mean-4.2 kPa change in TDF and-1.6 kPa in LAM,P0.05).The last available data on treatment showed that all had normal ALT,but more TDF patients were virologically suppressed(10 IU/mL)(n=170/190,89%)vs LAM-treated(n=35/58,60%)(P0.05).None cleared *** In this real-world North American study,approximately 5 years of NA achieves liver fibrosis regression rarely leads to HBsAg loss.