Shi Hong, Huang Mingxing, Lin Guoli, Li Xiangyong, Wu Yuankai, Jie Yusheng, Chong Yutian
Department of Infectious Disease, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
Department of Infectious Disease, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China.
Biomed Res Int. 2016;2016:6725073. doi: 10.1155/2016/6725073. Epub 2016 Mar 1.
To compare entecavir (ETV) and tenofovir disoproxil fumarate (TDF) effects in chronic hepatitis B (CHB) patients with high HBV DNA.
96 patients treated initially with tenofovir (TDF group) or entecavir (ETV group) were included in this retrospective study. The following parameters were assessed: HBeAg and hepatitis B e antibody (anti-HBe) status, serum alanine aminotransferase (ALT), and HBV-DNA levels at weeks 4, 12, 24, 36, 48, 60, 72, and 96; time to ALT normalization, undetectable HBV-DNA levels, and HBeAg seroconversion; total duration of follow-up and adverse reactions.
The patients included 66 (69%) and 30 (31%) individuals administered ETV and TDF, respectively, comprising 75% males. They were 35.1 ± 4.5 and 33.7 ± 4.6 years old in ETV and TDF groups, respectively. At 36 weeks, the response rate was significantly higher in the TDF group than in ETV treated patients (90% versus 69.7%, p = 0.03). At 48 weeks, less patients administered ETV showed undetectable HBV-DNA levels compared with the TDF group (86.4% versus 96.7%), a non-statistically significant difference (p = 0.13). Only 1 ETV treated patient developed virological breakthrough at 48-96 w. No adverse reactions were found.
ETV and TDF are comparable in efficacy and safety to suppress HBV-DNA replication in HBeAg-positive CHB patients with high HBV DNA.
比较恩替卡韦(ETV)和替诺福韦酯(TDF)对高乙肝病毒(HBV)DNA水平的慢性乙型肝炎(CHB)患者的疗效。
本回顾性研究纳入96例初治时使用替诺福韦(TDF组)或恩替卡韦(ETV组)的患者。评估以下参数:第4、12、24、36、48、60、72和96周时的HBeAg和乙肝e抗体(抗-HBe)状态、血清丙氨酸氨基转移酶(ALT)和HBV-DNA水平;ALT恢复正常、HBV-DNA水平检测不到和HBeAg血清学转换的时间;总随访时间和不良反应。
分别有66例(69%)和30例(31%)患者接受ETV和TDF治疗,男性占75%。ETV组和TDF组患者的年龄分别为35.1±4.5岁和33.7±4.6岁。在第36周时,TDF组的应答率显著高于接受ETV治疗的患者(90%对69.7%,p=0.03)。在第48周时,与TDF组相比,接受ETV治疗且HBV-DNA水平检测不到的患者较少(86.4%对96.7%),差异无统计学意义(p=0.13)。仅1例接受ETV治疗的患者在48 - 96周出现病毒学突破。未发现不良反应。
在抑制高HBV DNA的HBeAg阳性CHB患者的HBV-DNA复制方面,ETV和TDF在疗效和安全性上具有可比性。