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富马酸替诺福韦艾拉酚胺相对于恩替卡韦在慢性乙型肝炎病毒感染患者中降低血清 HBsAg 水平的优势:核苷(酸)类似物转换后的 144 周结局研究。

Superiority of tenofovir alafenamide fumarate over entecavir for serum HBsAg level reduction in patients with chronic HBV infection: A 144-week outcome study after switching of the nucleos(t)ide analog.

机构信息

Faculty of Medicine, Department of Gastroenterology & Hepatology, Saitama Medical University, Saitama, Japan.

出版信息

PLoS One. 2022 Feb 18;17(2):e0262764. doi: 10.1371/journal.pone.0262764. eCollection 2022.

Abstract

BACKGROUND

To evaluate the long-term efficacy of switching of the nucleos(t)ide analog used for treatment from entecavir (ETV) to tenofovir alafenamide fumarate (TAF) in patients with chronic HBV infection.

METHODS

A total of 103 patients with serum HBsAg levels of ≥100 IU/mL who had received ETV were enrolled. The nucleos(t)ide analog used for the treatment was switched from ETV to TAF, and the changes in serum HBsAg levels during the 144-week period before and after the drug switching were compared in 74 patients who had received ETV at least for 192 weeks.

RESULTS

Significant decreases of serum HBsAg levels were observed during both the ETV and the TAF administration period, although the degree of reduction was greater during the latter period than during the former period (P<0.001). Significant decreases of serum HBsAg levels were seen in both patients with genotype B HBV infection and genotype C HBV infection, irrespective of the serum HBsAg and HBcrAg levels at the time of the drug switching.

CONCLUSION

Switching of the nucleos(t)ide analog used for treatment from ETV to TAF merits consideration in patients with chronic HBV infection, since the extent of reduction of the serum HBsAg level was greater during the TAF treatment period than during the ETV treatment period.

摘要

背景

评估慢性乙型肝炎病毒(HBV)感染者由恩替卡韦(ETV)转换为富马酸替诺福韦艾拉酚胺(TAF)治疗的核苷(酸)类似物长期疗效。

方法

共纳入 103 例血清 HBsAg 水平≥100 IU/mL 的患者,他们接受 ETV 治疗。将核苷(酸)类似物治疗药物由 ETV 转换为 TAF,比较 74 例至少接受 192 周 ETV 治疗的患者在药物转换前和后 144 周期间血清 HBsAg 水平的变化。

结果

在 ETV 和 TAF 治疗期间,血清 HBsAg 水平均显著下降,尽管后者的下降程度大于前者(P<0.001)。无论在药物转换时的血清 HBsAg 和 HBcrAg 水平如何,乙型肝炎病毒基因型 B 和 C 感染者的血清 HBsAg 水平均显著下降。

结论

对于慢性 HBV 感染者,由 ETV 转换为 TAF 的核苷(酸)类似物治疗值得考虑,因为 TAF 治疗期间血清 HBsAg 水平的降低幅度大于 ETV 治疗期间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a18c/8856517/a17ad4045680/pone.0262764.g001.jpg

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