在完全抑制的多药耐药性乙型肝炎患者中，联合抗病毒治疗

StephenW

Gastroenterol Res Pract. 2018 Dec 16;2018:6948235. doi: 10.1155/2018/6948235. eCollection 2018.
Is Combination Antiviral Therapy Mandatory for Maintenance Therapy in Fully Suppressed Multidrug-Resistant Hepatitis B Patients?
Chung SW1, Chang Y1, Lee HY1, Cho EJ1, Lee JH1, Yu SJ1, Yoon JH1, Kim YJ1.
Author information
Abstract
Aim:

The efficacy of tenofovir disoproxil fumarate (TDF) monotherapy as maintenance therapy in multidrug-resistant (MDR) hepatitis B virus (HBV) patients after complete virologic suppression (CVS) has not been well evaluated. We evaluated the efficacy of maintenance TDF monotherapy compared with conventional TDF plus entecavir combination therapy after CVS of MDR HBV.
Methods:

In this single-center retrospective study, patients with MDR HBV who were previously treated with entecavir plus TDF combination therapy and achieved CVS were included. Patients were either maintained on entecavir plus TDF combination therapy or switched to TDF monotherapy after CVS. The primary endpoint was the virologic breakthrough, and secondary outcomes were liver cirrhosis (LC) or hepatocellular carcinoma (HCC) development. To overcome immortal time bias, time-varying Cox proportional hazard regression analysis was performed.
Results:

A total of 201 patients were included, and 153 patients were maintained on entecavir plus TDF combination therapy (combination group); 48 patients were converted from combination therapy to TDF monotherapy (single group) after CVS. Five patients experienced a virologic breakthrough, one patient in the single group owing to poor transient compliance and four patients in the combination group (P = 0.51). One new case of LC developed in the single group; five cases of LC developed in the combination group (P = 0.35). No new HCC development occurred in the single group, while seven cases of HCC developments were noted in the combination group. However, these results were not statistically significant (P = 0.54).
Conclusions:

For patients with suppressed HBV DNA, the efficacy of TDF monotherapy as maintenance therapy is comparable to that of entecavir plus TDF combination therapy.

PMID:
    30647735
PMCID:
    PMC6311770
DOI:
    10.1155/2018/694823

StephenW

Gastroenterol Res Pract。 2018年12月16日; 2018年：6948235。 doi：10.1155 / 2018/6948235。 eCollection 2018。
在完全抑制的多药耐药性乙型肝炎患者中，联合抗病毒治疗是否必须用于维持治疗？
Chung SW1，Chang Y1，Lee HY1，Cho EJ1，Lee JH1，Yu SJ1，Yoon JH1，Kim YJ1。
作者信息
抽象
目标：

替诺福韦地索普西富马酸盐（TDF）单药治疗在多药耐药（MDR）乙型肝炎病毒（HBV）患者完全病毒学抑制（CVS）后的疗效尚未得到很好的评估。我们评估了维持TDF单药治疗与MDR HBV CVS后常规TDF加恩替卡韦联合治疗的疗效。
方法：

在这项单中心回顾性研究中，纳入了先前接受恩替卡韦加TDF联合治疗并获得CVS的MDR HBV患者。患者要么维持恩替卡韦加TDF联合治疗，要么在CVS后转为TDF单药治疗。主要终点是病毒学突破，次要结果是肝硬化（LC）或肝细胞癌（HCC）发展。为了克服不朽的时间偏差，进行了时变Cox比例风险回归分析。
结果：

共纳入201例患者，153例患者接受恩替卡韦加TDF联合治疗（联合治疗组）; CVS后48例患者从联合治疗转为TDF单药治疗（单组）。 5名患者经历了病毒学突破，单组中1名患者由于短暂顺应性差，组合组中有4名患者（P = 0.51）。在单一组中开发了一个新的LC案例;联合组开发了5例LC（P = 0.35）。单一组未发生新的HCC发展，而组合组中发现7例HCC发展。然而，这些结果无统计学意义（P = 0.54）。
结论：

对于HBV DNA抑制的患者，TDF单药治疗作为维持治疗的疗效与恩替卡韦加TDF联合治疗相当。

结论：
    30647735
PMCID：
    PMC6311770
DOI：
    10.1155 /六十九万四千八百二十三分之二千〇一十八