Konya Petek, Demirtürk Neşe
Department of Infectious Disease and Clinical Microbiology, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey.
Infect Dis Clin Microbiol. 2022 Mar 10;4(1):47-54. doi: 10.36519/idcm.2022.78. eCollection 2022 Mar.
The main purpose of chronic hepatitis B (CHB) treatment is to improve the patients' life quality and prevent the disease from progressing to cirrhosis or hepatocellular carcinoma. Continuous suppression of hepatitis B virus (HBV) DNA with nucleoside or nucleotide analogues is the most critical way to achieve this goal. This study aimed to evaluate the CHB patients retrospectively followed up with tenofovir disoproxil fumarate (TDF) treatment.
The study was planned as retrospective research by Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology between January 2001 and December 2020. We evaluated all treatment-naive and treatment-experienced patients who received TDF (245 mg/day) treatment with the diagnosis of CHB. The data were obtained by reviewing the file information registered in the hospital automation system. HBsAg, Anti-HBs, HBeAg, Anti-HBe, HBV DNA, aspartate aminotransferase (AST), alanine aminotransferase (ALT) values of the patients were evaluated at 1st, 3rd, 6th, 12th months, and 6-month follow-ups throughout the treatment. Virological (HBV-DNA of < 50 IU/ml), biochemical (decrease below 40 IU/Ml in patients with pre-treatment value of ALT >40 IU/ml) and serological (Anti-HBe seroconversion in HBeAg positives and HBsAg negative and anti-HBs seroconversion in all patients) responses were examined. Adverse effects were also assessed during the treatment.
Data from 131 patients who received TDF treatment were evaluated. Virological responses were determined as 78.6%, 81.3%, 94.2%, and 100% in the patients at 24th week, 48th week, 4th year, and 8th year, respectively. While there was no Anti-HBs seroconversion in any patients in four years of the treatment, it was observed at a rate of 10.5% in the eighth year. We did not determine any significant adverse effects requiring discontinuation of the treatment in the long-term follow-up of 131 patients under TDF treatment.
As a result of our study, TDF was an effective and well-tolerated choice for CHB treatment.
慢性乙型肝炎（CHB）治疗的主要目的是提高患者生活质量，防止疾病进展为肝硬化或肝细胞癌。使用核苷或核苷酸类似物持续抑制乙型肝炎病毒（HBV）DNA是实现这一目标的最关键途径。本研究旨在对接受富马酸替诺福韦二吡呋酯（TDF）治疗的CHB患者进行回顾性随访评估。
本研究由阿菲永卡拉希萨尔健康科学大学医学院传染病与临床微生物学系于2001年1月至2020年12月规划为回顾性研究。我们评估了所有诊断为CHB且接受TDF（245mg/天）治疗的初治和经治患者。通过查阅医院自动化系统中登记的档案信息获取数据。在治疗的第1、3、6、12个月以及整个治疗过程中的6个月随访时，评估患者的乙肝表面抗原（HBsAg）、乙肝表面抗体（Anti-HBs）、乙肝e抗原（HBeAg）、乙肝e抗体（Anti-HBe）、HBV DNA、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）值。检查病毒学（HBV-DNA<50IU/ml）、生化（治疗前ALT>40IU/ml的患者ALT下降至40IU/Ml以下）和血清学（HBeAg阳性患者出现乙肝e抗体血清学转换且HBsAg阴性，所有患者出现乙肝表面抗体血清学转换）反应。治疗期间也评估不良反应。
评估了131例接受TDF治疗患者的数据。在第24周、48周、第4年和第8年时，患者的病毒学反应分别确定为78.6%、81.3%、94.2%和100%。在治疗的四年中，任何患者均未出现乙肝表面抗体血清学转换，而在第八年观察到转换率为10.5%。在131例接受TDF治疗患者的长期随访中，我们未确定任何需要停药的严重不良反应。
我们的研究结果表明，TDF是CHB治疗的一种有效且耐受性良好的选择。
