B型肝炎病毒量的長期變化趨勢和肝細胞癌的危險性:病例世代研究
Long-Term Patterns of Hepatitis B Viral Load and Risk of Hepatocellular Carcinoma: A Case-Cohort Study
Date Issued
2006
Date
2006
Author(s)
Wu, Chih-Feng
DOI
en-US
Abstract
Background: Hepatitis B viral load measured in terms of circulating hepatitis B virus (HBV) DNA levels has been associated with hepatocellular carcinoma (HCC) risk. The specific aims of this study were threefold: 1) to explore the long-term patterns of HBV viral load; 2) to assess the influence of HBV genotype and other factors on the tracking of HBV viral load over time; and 3) to examine the long-term patterns of HBV viral load and subsequent risk of developing HCC after adjusting for viral genotype. Methods: A case-cohort study was conducted within a cohort of male HBV carriers whose initial blood samples were taken in 1989-1992. We used PCR-based assays to determine HBV viral load and genotype on 7706 plasma samples, collected during a period of up to 16 years of follow-up, from a total of 112 individuals who subsequently developed HCC and 1031 unaffected individuals. A weighted Cox’s proportional hazards model was used to assess the association between viral factors and HCC. We evaluated tracking of HBV viral load using the generalized linear mixed model. Results: Carriers of genotype C HBV had a significantly higher HBV viral load than carriers of genotype B HBV (P < 0.001). HBV genotype influenced the decreasing trend of viral load with age (P for age×genotype interaction < 0.001). Over a period of 16 years, both stability coefficients and tracking for subjects at risk for HBV viral load were high, indicating high predictability of initial measurements for values within 16 years. The HCC risk increased with increasing duration of having at-risk viral load, defined as ≥ 4.386 log10 copies/mL, showing adjusted hazard ratios were 5.00 (95% confidence interval [CI] = 2.73 to 9.16), 6.71 (95% CI = 3.07 to 14.67), 9.17 (95% CI = 2.59 to 32.48), respectively, for duration of persistence within 3, 6, 9 years of the initial measurement. Conclusions: Tracking of HBV viral load after long-term follow-up was high. Duration of persistence for having at-risk viral load was positively associated risk of HCC. Our data recommend that the prophylactic intervention for active viral infection should be at earlier ages among HBV carriers aged 30 years or older.
Subjects
B型肝炎病毒
B型肝炎病毒量
病例世代研究
重覆性測量
循跡分析
B型肝炎病毒之基因型
HBV
HBV viral load
case-cohort study
repeated measurements
tracking analysis
HBV genotype
SDGs
Type
thesis
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