Department of Infectious Diseases and Clinic Microbiology, Sakarya University, Faculty of Medicine, Sakarya, Turkey.
Department of Public Health, Sakarya University, Faculty of Medicine, Sakarya, Turkey.
Indian J Pharmacol. 2023 Jan-Feb;55(1):14-20. doi: 10.4103/ijp.ijp_851_21.
It was intended to assess the efficacy of lamivudine, entecavir, and tenofovir regimens in the management of chronic hepatitis B (CHB) guided by Fibrosis-4 (FIB-4) and aspartate aminotransferase-to-platelet ratio index (APRI) scores.
Our study was conducted on patients who applied to the hepatitis outpatient clinic between 2008 and 2015 retrospectively. Lamivudine, entecavir, and tenofovir regimens used in the practice of CHB cases were compared by measuring noninvasive FIB tests.
Entirely 199 patients involved in the research were evaluated in three treatment arms; 48 used lamivudine, 46 used entecavir, and 105 used tenofovir. Similar statistical characteristics were observed between research arms regarding age, gender, and alanine aminotransferase normalization by years (P > 0.05). Totally 5 (13.5%) of patients developed Hepatitis B e antigen (HBeAg) seroconversion among 36 HBeAg positivity, and similar statistical features were seen by comparing the groups (P > 0.05). In the entecavir and tenofovir arms, a significant decrease was seen in FIB-4, and APRI index values in the 1st year of treatment (P < 0.001). At the graph curve, a plateau was observed in the APRI test after the 1 year, and a plateau was observed in the FIB-4 test after the 2 year.
Consistent with the study outcome, when we consider FIB regression, tenofovir and entecavir regimens were found more effective than lamivudine. In addition, entecavir was more effective than the other two drugs after the 1 year.
本研究旨在评估 Fibrosis-4（FIB-4）和天冬氨酸氨基转移酶与血小板比值指数（APRI）评分指导下，拉米夫定、恩替卡韦和替诺福韦方案治疗慢性乙型肝炎（CHB）的疗效。
本研究回顾性分析了 2008 年至 2015 年期间在肝炎门诊就诊的患者。通过测量非侵入性 FIB 试验，比较了 CHB 病例中使用的拉米夫定、恩替卡韦和替诺福韦方案。
共有 199 例患者被纳入研究，分为三组：48 例使用拉米夫定、46 例使用恩替卡韦、105 例使用替诺福韦。在年龄、性别和丙氨酸氨基转移酶正常化率方面，研究组之间的统计特征相似（P＞0.05）。在 36 例 HBeAg 阳性患者中，有 5 例（13.5%）发生了 HBeAg 血清学转换，且各组间的统计特征相似（P＞0.05）。在恩替卡韦和替诺福韦组中，治疗第 1 年 FIB-4 和 APRI 指数值显著下降（P＜0.001）。在图表曲线上，APRI 测试在第 1 年后出现平台期，FIB-4 测试在第 2 年后出现平台期。
与研究结果一致，当我们考虑 FIB 回归时，替诺福韦和恩替卡韦方案比拉米夫定更有效。此外，恩替卡韦在治疗 1 年后比其他两种药物更有效。
