Jiang Y F, He B, Ma J, Li N-P, Gong G-Z, Cheng D
Liver Diseases Research Center, Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.
Acta Gastroenterol Belg. 2012 Sep;75(3):316-21.
The purpose of this study is to compare the antiviral efficacy of entecavir (ETV) and adefovir dipivoxil (ADV) at various time points during the treatment.
A randomized, controlled, open-label study was designed to analyze the kinetics of HBeAg seroconversion, HBV DNA level, and liver and renal functions in 72 ETV-treated chronic hepatitis B (CHB) patients and 66 ADV-treated CHB patients. The data was collected every 12 weeks up to 96 weeks after drug administration.
The negative rate of HBeAg seroconversion was significantly increased at 24 weeks in ETV-treated patients, whereas in ADV-treated patients, these changes were not significant. The serum HBV DNA levels were significantly decreased from 24 weeks in both ETV- and ADV-treated patients. Other than ETV showing significantly decreased levels of HBV DNA at 24 weeks when compared with ADV, there was no difference in virological response between two treatments at any other time points. The serum alanine aminotransferase (ALT) and total bilirubin (TBIL) levels were significantly decreased 12 weeks after either ETV- or ADV-treated patients without differences between two treatments. The urea nitrogen levels were in normal range and there was no difference between two groups.
Our study suggested that both ETV and ADV could be used as monotherapy for nucleotide-naive patients, but ETV has displayed potential efficacy in HBeAg seroconversion.
本研究旨在比较恩替卡韦(ETV)和阿德福韦酯(ADV)在治疗期间不同时间点的抗病毒疗效。
设计了一项随机、对照、开放标签研究,以分析72例接受ETV治疗的慢性乙型肝炎(CHB)患者和66例接受ADV治疗的CHB患者的HBeAg血清学转换动力学、HBV DNA水平以及肝肾功能。在给药后长达96周的时间里,每12周收集一次数据。
ETV治疗组患者在24周时HBeAg血清学转换阴性率显著升高,而ADV治疗组患者的这些变化不显著。ETV和ADV治疗组患者血清HBV DNA水平自24周起均显著下降。除ETV在24周时与ADV相比HBV DNA水平显著降低外,两种治疗在其他任何时间点的病毒学应答均无差异。ETV或ADV治疗患者在治疗12周后血清丙氨酸氨基转移酶(ALT)和总胆红素(TBIL)水平均显著下降,两种治疗之间无差异。尿素氮水平在正常范围内,两组之间无差异。
我们的研究表明,ETV和ADV均可作为初治患者的单药治疗,但ETV在HBeAg血清学转换方面显示出潜在疗效。