替诺福韦对慢性乙型肝炎病毒感染患者肝脏组织病理学的长期影响。
Long-Term Effects of Tenofovir on Liver Histopathology in Patients with Chronic Viral Hepatitis B Infection.
作者信息
Tatar Bengü, Gül Selma, Köse Şükran, Pala Emel
机构信息
Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences ,Izmir Tepecik Education and Research Hospital, IZMIR, TURKEY.
出版信息
Turk Patoloji Derg. 2020;1(1):154-158. doi: 10.5146/tjpath.2020.01478.
OBJECTIVE
The aim of this study to evaluate histopathological improvement and virological, serological and biochemical response rates in patients with chronic hepatitis B (CHB) who were treated with tenofovir disoproxil fumarate (TDF).
MATERIAL AND METHOD
A total of 91 nucleosid(t)e-naive CHB patients who received TDF were evaluated. Virological, serological and biochemical test results were assessed at baseline and every 12 weeks. Liver biopsy specimens were assessed according to the modified Ishak scoring.
RESULTS
The study was conducted on 52 patients. The mean age was 40±10 years and 40.4% were female. The mean follow-up period was 33±11 months. HBsAg seroclearance occurred in none of the patients. The serum level of HBV-DNA became undetectable in 94.2% of the patients. Mean histological activity index at baseline and on-treatment were 8.2±2.3 and 6.2±2.0 and the mean fibrosis scores were 2.65±1.3 and 2.33±1.1, respectively.
CONCLUSION
We determined that TDF therapy provided remarkably good HBV DNA suppression and biochemical response rates, but low seroconversion. Improvement of liver necroinflammation was detected, but no significant change observed in fibrosis.
目的
本研究旨在评估接受替诺福韦酯（TDF）治疗的慢性乙型肝炎（CHB）患者的组织病理学改善情况以及病毒学、血清学和生化反应率。
材料与方法
共评估了91例初治核苷（酸）类药物的CHB患者，这些患者接受了TDF治疗。在基线时以及每12周评估病毒学、血清学和生化检测结果。根据改良的Ishak评分对肝活检标本进行评估。
结果
该研究纳入了52例患者。平均年龄为40±10岁，女性占40.4%。平均随访期为33±11个月。所有患者均未出现HBsAg血清学清除。94.2%的患者血清HBV-DNA水平降至不可检测。基线时和治疗期间的平均组织学活动指数分别为8.2±2.3和6.2±2.0，平均纤维化评分分别为2.65±1.3和2.33±1.1。
结论
我们确定TDF治疗可显著抑制HBV DNA并获得良好的生化反应率，但血清学转换率较低。检测到肝脏坏死性炎症有所改善，但纤维化未见明显变化。
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