富马酸替诺福韦艾拉酚胺酯对慢性乙型肝炎患者血脂谱的影响。
Effects of tenofovir alafenamide fumarate on serum lipid profiles in patients with chronic hepatitis B.
机构信息
Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, No. 321 Zhongshan Road, Nanjing, Jiangsu, 210008, China.
Department of Clinical Laboratory, Huai'an No. 4 People's Hospital, Huai'an, Jiangsu, China.
出版信息
Virol J. 2024 Sep 28;21(1):234. doi: 10.1186/s12985-024-02515-7.
BACKGROUND
Concerns have been raised regarding changes in lipid profiles among patients with chronic hepatitis B (CHB) during tenofovir alafenamide fumarate (TAF) treatment. We aimed to evaluate the effect of TAF treatment on the lipid profiles of patients with CHB.
METHODS
A total of 430 patients with CHB from three hospitals were retrospectively included, including 158 patients treated with TAF and 272 patients treated with tenofovir disoproxil fumarate (TDF).
RESULTS
In this multicenter cohort, the cumulative incidence of dyslipidemia was notably higher in the TAF group than in the TDF group (P < 0.001). After TAF treatment, a significant elevation was observed in triglyceride (TG) levels (from 0.83 mmol/L to 1.02 mmol/L, P < 0.001) and total cholesterol (TC) levels (from 4.16 mmol/L to 4.32 mmol/L, P < 0.001). Similar changes in TG and TC levels were observed in the TAF group after propensity score matching (PSM). The TG levels (from 0.83 mmol/L to 1.04 mmol/L, P < 0.001) and TC levels (from 4.16 mmol/L to 4.38 mmol/L, P < 0.001) were both increased significantly compared to the baseline levels in the PSM cohort of patients treated with TAF. TAF treatment was independently associated with elevated TG levels (HR = 2.800, 95% CI: 1.334-5.876, P = 0.006) and TC levels (HR = 9.045, 95% CI: 3.836-21.328, P < 0.001).
CONCLUSIONS
Compared with TDF treatment, TAF treatment was associated with dyslipidemia in patients with CHB. Close monitoring of lipid profiles is needed in patients with CHB who received TAF treatment.
背景
替诺福韦艾拉酚胺富马酸酯（TAF）治疗期间，慢性乙型肝炎（CHB）患者的血脂谱发生变化，引起了人们的关注。我们旨在评估 TAF 治疗对 CHB 患者血脂谱的影响。
方法
回顾性纳入来自三所医院的 430 例 CHB 患者，其中 158 例接受 TAF 治疗，272 例接受替诺福韦酯（TDF）治疗。
结果
在这项多中心队列研究中，TAF 组的血脂异常累积发生率明显高于 TDF 组（P<0.001）。TAF 治疗后，甘油三酯（TG）水平显著升高（从 0.83mmol/L 升至 1.02mmol/L，P<0.001），总胆固醇（TC）水平也显著升高（从 4.16mmol/L 升至 4.32mmol/L，P<0.001）。在倾向评分匹配（PSM）后，TAF 组也观察到 TG 和 TC 水平的类似变化。与 TAF 治疗的 PSM 队列患者的基线水平相比，TG 水平（从 0.83mmol/L 升至 1.04mmol/L，P<0.001）和 TC 水平（从 4.16mmol/L 升至 4.38mmol/L，P<0.001）均显著升高。TAF 治疗与 TG 水平升高独立相关（HR=2.800，95%CI：1.334-5.876，P=0.006）和 TC 水平升高独立相关（HR=9.045，95%CI：3.836-21.328，P<0.001）。
结论
与 TDF 治疗相比，TAF 治疗与 CHB 患者的血脂异常相关。接受 TAF 治疗的 CHB 患者需要密切监测血脂谱。
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