Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osakasayama, Japan.
J Med Virol. 2019 Oct;91(10):1804-1810. doi: 10.1002/jmv.25515. Epub 2019 Jul 2.
Tenofovir alafenamide (TAF) is a newly developed prodrug of tenofovir (TFV). We divided 48 chronic hepatitis B patients who had taken entecavir (ETV) for ≥2 years into two groups: the ETV continuation (n = 24) and the TAF switching (n = 24) groups, and compared the antiviral effects and safety until 48 weeks after the start of the study. There were no significant differences in the alterations in the serum levels of HBs antigen (HBsAg) level between the ETV continuation and the TAF switching groups at 24 or 48 weeks. We also examined the effect of baseline HBsAg level on the decrease of HBsAg during the treatment; in the TAF switching group, the decrease of HBsAg level at 48 weeks was more significant in patients with low baseline HBsAg (<800 IU/mL) than those with high baseline HBsAg ( >800 IU/mL) (change of HBsAg; - 0.029 vs - 0.132 for high and low baseline HBsAg, respectively, P = .007). Also, the effect on renal function was found to be comparable between the TAF switch group and the ETV continuation group. In this study, switching from ETV to TAF may represent higher efficacy for a decrease of HBsAg than a continuation of ETV among the patients with low baseline HBsAg level.
替诺福韦艾拉酚胺（TAF）是一种新开发的替诺福韦（TFV）前药。我们将 48 名已服用恩替卡韦（ETV）≥2 年的慢性乙型肝炎患者分为两组：ETV 继续治疗组（n=24）和 TAF 转换组（n=24），并比较研究开始后 48 周内的抗病毒效果和安全性。在 24 周或 48 周时，ETV 继续治疗组和 TAF 转换组的血清 HBs 抗原（HBsAg）水平变化没有显著差异。我们还检查了基线 HBsAg 水平对治疗期间 HBsAg 下降的影响；在 TAF 转换组中，低基线 HBsAg（<800IU/mL）患者的 HBsAg 水平在 48 周时下降更为显著，高于高基线 HBsAg（>800IU/mL）患者（HBsAg 变化：高基线 HBsAg 患者为 -0.029，低基线 HBsAg 患者为 -0.132，P=0.007）。此外，TAF 转换组和 ETV 继续治疗组的肾功能影响相当。在这项研究中，与 ETV 继续治疗相比，低基线 HBsAg 水平的患者从 ETV 转换为 TAF 可能代表 HBsAg 下降的疗效更高。
