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富马酸替诺福韦二吡呋酯与恩替卡韦治疗慢性乙型肝炎患者的疗效比较。

A comparison of the therapeutic efficacy of Tenofovir Disoproxil Fumarate and Entecavir in patients with chronic Hepatitis-B.

作者信息

Wang Huan, Wu Liping

机构信息

Huan Wang Department of Infectious, First People's Hospital of Linping District, Hangzhou, Zhejiang Province 311100, P.R. China.

Liping Wu Department of General Geriatrics, Linping District Integrated Traditional, Chinese and Western Medicine Hospital, Hangzhou, Zhejiang Province 311100, P.R. China.

出版信息

Pak J Med Sci. 2024 Nov;40(10):2390-2394. doi: 10.12669/pjms.40.10.10307.

Abstract

OBJECTIVE

To compare the therapeutic efficacy of tenofovir disoproxil fumarate (TDF) and entecavir (ETV) in patients with chronic Hepatitis-B (CHB).

METHODS

This retrospective study included 110 patients with CHB who received treatment at The First People's Hospital of Linping District, Hangzhou from January 2021 to January 2023. Clinical data of the patients were reviewed and the patients were classified according to the treatment received: TDF group (n=53, patients received TDF treatment) and ETV group (n=57, patients received ETV treatment). Hepatitis-B virus deoxyribonucleic acid (HBV DNA) levels, liver function indicators, hepatitis-B e antigen (HBeAg) seroconversion rate, alanine transaminase (ALT) normalization rate, HBV DNA negative conversion rate, overall efficacy, and incidence of adverse reactions were compared.

RESULTS

The total efficacy of the treatment in the TDF group was 94.33%, significantly higher than that in the ETV group (78.95%; <0.05). After the treatment, the HBV DNA levels in both groups decreased compared to pretreatment levels, and were significantly lower in the TDF group compared to the ETV group (<0.05). Both groups showed significant post-treatment improvement in liver function that was markedly better in the TDF group compared to the ETV group (<0.05). The HBeAg seroconversion rate, ALT normalization rate, and HBV DNA conversion rate in the TDF group were significantly higher compared to the ETV group (<0.05). There was no difference in the incidence of adverse reactions between the two groups.

CONCLUSIONS

Compared with ETV, TDF has comparable adverse reaction profile but has more significant clinical effects in patients with CHB, improving HBeAg seroconversion rate, ALT normalization rate, and HBV DNA negative conversion rate. TDF is associated with lower HBV DNA levels after treatment and better improvements in liver function of patients.

摘要

目的

比较替诺福韦酯(TDF)与恩替卡韦(ETV)对慢性乙型肝炎(CHB)患者的治疗效果。

方法

本回顾性研究纳入了2021年1月至2023年1月在杭州市临平区第一人民医院接受治疗的110例CHB患者。回顾患者的临床资料,并根据接受的治疗将患者分类:TDF组(n = 53,接受TDF治疗的患者)和ETV组(n = 57,接受ETV治疗的患者)。比较乙型肝炎病毒脱氧核糖核酸(HBV DNA)水平、肝功能指标、乙肝e抗原(HBeAg)血清学转换率、谷丙转氨酶(ALT)复常率、HBV DNA阴转率、总体疗效及不良反应发生率。

结果

TDF组治疗总有效率为94.33%,显著高于ETV组(78.95%;P<0.05)。治疗后,两组HBV DNA水平均较治疗前下降,且TDF组显著低于ETV组(P<0.05)。两组治疗后肝功能均有显著改善,且TDF组明显优于ETV组(P<0.05)。TDF组的HBeAg血清学转换率、ALT复常率和HBV DNA转阴率均显著高于ETV组(P<0.05)。两组不良反应发生率无差异。

结论

与ETV相比,TDF不良反应相当,但对CHB患者临床效果更显著,可提高HBeAg血清学转换率、ALT复常率及HBV DNA阴转率。TDF治疗后患者HBV DNA水平更低,肝功能改善更佳。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1538/11568734/4ef9cb0eae68/PJMS-40-2390-g001.jpg

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