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替诺福韦与恩替卡韦对乙肝 e 抗原阳性且乙肝病毒 DNA 水平高的慢性乙型肝炎患者的疗效比较

Efficacy Comparison of Tenofovir and Entecavir in HBeAg-Positive Chronic Hepatitis B Patients with High HBV DNA.

作者信息

Shi Hong, Huang Mingxing, Lin Guoli, Li Xiangyong, Wu Yuankai, Jie Yusheng, Chong Yutian

机构信息

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.

出版信息

Biomed Res Int. 2016;2016:6725073. doi: 10.1155/2016/6725073. Epub 2016 Mar 1.

Abstract

OBJECTIVES

To compare entecavir (ETV) and tenofovir disoproxil fumarate (TDF) effects in chronic hepatitis B (CHB) patients with high HBV DNA.

METHOD

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.

RESULTS

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.

CONCLUSION

ETV and TDF are comparable in efficacy and safety to suppress HBV-DNA replication in HBeAg-positive CHB patients with high HBV DNA.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd5a/4791504/d278e2a461ec/BMRI2016-6725073.001.jpg

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