Chronic Hepatitis B Infection with Low Level Viremia Correlates with the Progression of the Liver Disease

查看全文 作　　者：Qian [1]Zhang;Hong [2]Peng;Xiaoqing [1]Liu;Huimin [1]Wang;Jinjie [1]Du;Xinhua [2]Luo;Hong [1]Ren;Peng [1]Hu

机构地区：[1]Department of Infectious Diseases,Institute for Viral Hepatitis,The Key Laboratory of Molecular Biology for Infectious Diseases,Chinese Ministry of Education,The Second Affiliated Hospital of Chongqing Medical University,Chongqing,China;[2]Department of Infectious Diseases,Guizhou Provincial People’s Hospital,Guiyang,Guizhou,China

出　　处：《Journal of Clinical and Translational Hepatology》索引2021年第9卷第6期,共10页

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. 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 occurs.This study compared the clinical out-comes of patients with a maintained virological response(MVR)and patients who experienced LLV and their treatment strategies.Methods: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 period.End-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 matching.In the high-risk group of four HCC risk models,LLV patients had a higher risk of HCC development(p<0.05).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(p<0.05).Conclusions:LLV is an independent risk factor for end-stage liver disease and HCC,and treatment adjustments can be considered. 关键词：Low-level viremia Chronic hepatitis B End-stage liver disease Hepatocellular carcinoma Treatment strategies

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Chronic Hepatitis B Infection with Low Level Viremia Correlates with the Progression of the Liver Disease

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