功效和替比夫定和恩替卡韦的肾脏安全性在治疗过的老年慢

StephenW

European Journal of Gastroenterology & Hepatology:
February 2016 - Volume 28 - Issue 2 - p 193–198
doi: 10.1097/MEG.0000000000000519
Original Articles: Hepatitis
Comparison of efficacy and renal safety of telbivudine and entecavir in treatment-naive elderly patients with chronic hepatitis B

Law, Siu-tong; Lee, Ming Kai; Li, Kin Kong; Mok, Chun Keung

Abstract

Background: Data comparing the clinical outcomes of telbivudine (LdT) and entecavir (ETV) in elderly patients with chronic hepatitis B are limited.

Goals: The aim of the present study was to compare the efficacy and renal safety of LdT and ETV in treatment-naive elderly (≥60 years) patients with chronic hepatitis B.

Methods: A total of 33 patients treated with LdT were consecutively enrolled in the study. Each patient was matched on the basis of age, sex, and baseline hepatitis B virus (HBV) DNA levels with three to four randomly selected controls treated with ETV.

Results: Clinical characteristics were comparable between the two groups. Higher cumulative HBeAg-seroconversion rates were observed in the LdT group than in the ETV group after 2 years (50 vs. 20%) and 3 years (50 vs. 26.67%) of treatment (all P<0.0001). Virological response rate at week 24 was significantly lower in the LdT group than it was in the ETV group (54.55 vs. 70.87%, P<0.0001), but no significant difference was noted in long-term cumulative rates of undetectable HBV DNA levels between the two groups (P=0.562). Virological breakthrough occurred in six (18.18%) LdT patients, with no such cases reported in the ETV group (P<0.0001). Antiviral resistance was strongly associated with LdT use and the absence of undetectable HBV DNA at weeks 12 and 24 (P<0.0001). During the study, significant improvement was observed in the estimated glomerular filtration rate and model for end-stage liver disease score in LdT versus ETV group.

Conclusion: LdT has a lower clinical efficacy for viral suppression and a higher risk of antiviral resistance than does ETV. However, LdT resulted in higher HBeAg-seroconversion rates and better renoprotective effects than did ETV.

StephenW

欧洲胃肠病学和肝病学：
2016年2月 - 28卷 - 第2期 - P 193-198
DOI：10.1097 / MEG.0000000000000519
原创文章：肝炎
功效和替比夫定和恩替卡韦的肾脏安全性在治疗过的老年慢性乙型肝炎比较

法棠;利铭凯;李，建港;莫春强

抽象

背景：在老年慢性乙型肝炎比较替比夫定（LDT）和恩替卡韦（ETV）的临床结局的数据是有限的。

目标：本研究的目的是比较在治疗过的老人（≥60岁）的有效性和LDT和恩替卡韦的肾脏安全性治疗慢性乙型肝炎

方法：用LDT治疗的33例患者连续参加了学习。每个病人相匹配的年龄，性别，和基线乙型肝炎病毒（HBV）DNA水平的基础上用三到四连ETV处理随机选择的控制上。

结果：临床特征具有可比性的两组。较高的累计e抗原血清转换率观察到LDT​​组较ETV组经过2年（50对20％）和3年的治疗（50对26.67％）（均P <0.0001）。病毒学应答率在24周是显著降低的LDT组较这是恩替卡韦组（54.55与70.87％，P <0.0001），但没有显著差异注意到之间无法检测HBV DNA水平的长期累积利率两个组（P = 0.562）。病毒学突破发生在六（18.18％）LDT患者，报道了恩替卡韦组（P <0.0001）中没有这样的情况。抗病毒抗性是紧密联系在一起LDT使用和缺乏的检测不到的HBV DNA在周12和24（P <0.0001）相关联。在研究过程中，显著的改善，观察，估计肾小球滤过率和模型，用于LDT终末期肝病评分与恩替卡韦组。

结论：LDT具有较低的临床功效为病毒抑制和抗病毒抗性比确实ETV的更高的风险。然而，LDT导致更高的HBeAg血清转换率，比较ETV有更好肾脏的保护作用。

重韧

想说明是LTD 的更高的HBEAG的转阴率，但是没有ETV 对肾脏这么安全

StephenW

回复 重韧 的帖子

错译. 应该是:
LDT比较ETV有更好肾脏的保护作用。