Lamivudine versus entecavir in the rescue of chemotherapy-induced hepatitis B flare-up

Yi Jun Liao, Yen Chang Li, Shou Wu Lee, Chun Ying Wu, Sheng Shun Yang, Hong Zen Yeh, Chi Sen Chang, Teng Yu Lee*

*此作品的通信作者

研究成果: Article同行評審

8 引文 斯高帕斯(Scopus)

摘要

Background Lack of nucleos(t)ide analogue (NA) prophylaxis prior to chemotherapy is a common problem worldwide. The efficacy of newer-generation NAs in the rescue for the hepatitis B virus (HBV) reactivation has not been confirmed. We aimed to compare lamivudine (LVD) and entecavir (ETV) in the rescue of chemotherapy-induced HBV flare-up. Methods In this retrospective cohort study, we screened all HBV carriers who received therapeutic LVD or ETV for hepatitis flare-up after chemotherapy between January 1, 2004 and December 31, 2015. Patients who had other concurrent primary liver diseases such as chronic hepatitis C, who had baseline HBV viral load <2000 IU/ml or data unavailable, or those who had primary or secondary liver cancers were excluded. By means of propensity scores, LVD users were randomly matched 1:1 with ETV users. Cumulative incidences of, and hazard ratios (HRs) for, mortality at 6 months were analyzed, and 1-year virological responses were evaluated. Results In total, 32 LVD and 32 ETV users were matched for outcome analysis, and their baseline characteristics were not significantly different. Comparing LVD users to ETV users, the 6-month liver-related mortality rates (6.3% vs. 12.5%, p = 0.47) and overall mortality rates (31.3% vs. 25%, p = 0.54) were not significantly different. In multivariate analysis, prothrombin time prolongation >4 s (HR: 10.78, 95% confidence interval [CI]: 1.55–74.93) and HBV viral load L (HR: 3.40 per 1 log IU/ml, 95% CI: 1.39–8.40) were independent prognostic factors for liver-related mortality. There was no drug resistance to LVD or ETV over the course of 1 year. Conclusion Clinical outcomes were not different between LVD and ETV users. Delayed detection of hepatitis flare-up with coagulopathy and a high viral load could result in a poor prognosis.

原文English
頁(從 - 到)758-765
頁數8
期刊Journal of the Chinese Medical Association
80
發行號12
DOIs
出版狀態Published - 12月 2017

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