治疗初期慢性乙型肝炎患者恩替卡韦和替诺福韦的长期疗效

StephenW

BMC Gastroenterol. 2017 Mar 9;17(1):39. doi: 10.1186/s12876-017-0596-7.
Comparison of the long-term efficacy between entecavir and tenofovir in treatment- naïve chronic hepatitis B patients.Park JW1,2, Kwak KM3,4, Kim SE1, Jang MK5, Suk KT6, Kim DJ6, Park SH7, Lee MS7, Kim HS8, Park CK1.
Author information
1Department of Internal Medicine, Hallym University Sacred Heart Hospital of Hallym University Medical Center, 22, Gwanpyeong-ro 170 beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do, 14068, Republic of Korea.2Department of Biomedical Gerontology, Graduate School of Hallym University, 1 Hallymdaehak-gil, Chuncheon-si, Gangwon-do, 24252, Republic of Korea.3Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital of Hallym University Medical Center, 22, Gwanpyeong-ro 170 beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do, 14068, Republic of Korea.4Department of Environmental Health, Seoul National University School of Public Health, 1, Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea.5Department of Internal Medicine, Kangdong Sacred Heart Hospital of Hallym University Medical Center, 18, Cheonho-daero 173-gil, Gangdong-gu, Seoul, 05355, Republic of Korea.6Department of Internal Medicine, Chuncheon Sacred Heart Hospital of Hallym University Medical Center, 77, Sakju-ro, Chuncheon-si, Gangwon-do, 24253, Republic of Korea.7Department of Internal Medicine, Kangnam Sacred Heart Hospital of Hallym University Medical Center, 1, Singil-ro, Yeongdeungpo-gu, Seoul, 07441, Republic of Korea.8Department of Internal Medicine, Kangdong Sacred Heart Hospital of Hallym University Medical Center, 18, Cheonho-daero 173-gil, Gangdong-gu, Seoul, 05355, Republic of Korea. [email protected].

AbstractBACKGROUND: There have been limited studies directly comparing the long-term efficacy between entecavir (ETV) and tenofovir disoproxil fumarate (TDF). This study was aimed to compare the long-term efficacy between them in treatment-naïve chronic hepatitis B (CHB).
METHODS: Out of 345 CHB patients who received first line therapy with ETV (n = 200) or TDF (n = 145) in a cohort, 210 patients were analyzed using propensity score matching, at a ratio of 1:1.
RESULTS: Two groups showed no difference in baseline characteristics. During the follow-up of 12 months, HBV DNA levels were similarly suppressed in both groups (ETV vs. TDF; -5.01 vs. -5.242 log10IU/mL, P = 0.559). At month 12, both groups showed no difference in terms of the serologic, biochemical and virologic (VR) response. In multivariate analysis, the initial virologic response at 3 months (IVR-3) was independent factor for VR at 1 year. During the long-term follow-up, HBV DNA levels were more strongly suppressed by TDF than ETV in hepatitis B e antigen (HBeAg) positive patients (P = 0.035), especially with high viral load (P = 0.012), although there was no significant difference in overall VR between two groups. The type of antivirals was not an independent factor for long-term VR.
CONCLUSIONS: Although either ETV or TDF, overall, may show a comparable long-term antiviral efficacy in treatment-naïve CHB, TDF might be better regimen than ETV in the subgroup of HBeAg-positive CHB, especially with a higher HBV DNA levels.


KEYWORDS: Entecavir; Hepatitis B virus; Tenofovir

PMID:28279168DOI:10.1186/s12876-017-0596-7

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StephenW

BMC Gastroenterol。 2017年3月9日; 17（1）：39。 doi：10.1186 / s12876-017-0596-7。
治疗初期慢性乙型肝炎患者恩替卡韦和替诺福韦的长期疗效比较。
Park JW1,2，Kwak KM3,4，Kim SE1，Jang MK5，Suk KT6，Kim DJ6，Park SH7，Lee MS7，Kim HS8，Park CK1。
作者信息

1
    韩国大学内科学部韩国大学医学中心圣心医院神戸大学医学中心神戸大学医学中心神戸大学医学中心神戸大学医学中心神经内科
2
    生物医学老年学系，韩国大学研究生院，1 Hallymdaehak-gil，春川，江原道，24252，韩国。
3
    河内大学职业环境医学科Hallym大学医学中心神圣心脏病医院，22，Gwanpyeong-ro 170 beon-gil，Dongan-gu，Anang-si，Gyeonggi-do，14068，大韩民国。
4
    首尔大学公共卫生学院环境卫生系1，Gwanak-ro，Gwanak-gu，Seoul，08826，韩国。
5
    内科学部韩国大学医学中心Kangdong神圣心脏病医院，18，Cheonho-daero 173-gil，Gangdong-gu，Seoul，05355，韩国。
6
    内科学部韩国大学医学中心Chuncheon神圣心脏病医院，77，Sakju-ro，Chuncheon-si，Gangwon-do，24253，韩国。
7
    内科学，韩国Hallym大学医学中心，1，Singil-ro，永登浦区，首尔，韩国，07441，韩国Kangnam神圣心脏病医院。
8
    内科学部韩国大学医学中心Kangdong神圣心脏病医院，18，Cheonho-daero 173-gil，Gangdong-gu，Seoul，05355，韩国。 [email protected]。

抽象
背景：

有限的研究直接比较恩替卡韦（ETV）和替诺福韦地索普西富马酸盐（TDF）的长期疗效。这项研究旨在比较他们之间在治疗初始慢性乙型肝炎（CHB）的长期疗效。
方法：

在队列中接受ETV（n = 200）或TDF（n = 145）的一线治疗的345例CHB患者中，使用倾向得分匹配以1:1的比例分析210名患者。
结果：

两组在基线特征方面没有显示出差异。在12个月的随访期间，两组（ETV与TDF; -5.01相对于-5.242log10IU / mL，P = 0.559）的HBV DNA水平类似地被抑制。在第12个月，两组在血清学，生化和病毒学（VR）反应方面没有显示出差异。在多变量分析中，3个月时的初始病毒学反应（IVR-3）是1年时VR的独立因素。在长期随访期间，乙型肝炎e抗原（HBeAg）阳性患者（P = 0.035），特别是高病毒载量（P = 0.012），乙型肝炎病毒DNA水平更强烈抑制TDF比ETV，虽然有两组总体VR差异无统计学意义。抗病毒药物的类型不是长期VR的独立因素。
结论：

尽管ETV或TDF总体上可能在未治疗的CHB中显示出可比较的长期抗病毒功效，但是在HBeAg阳性CHB亚组中，尤其是具有更高的HBV DNA水平的TDF可能是比ETV更好的方案。
关键词：

恩替卡韦乙型肝炎病毒;替诺福韦

PMID：
    28279168
DOI：
    10.1186 / s12876-017-0596-7

TRUMPHILARY

此文结论，简单概括为：
慢性乙肝抗病毒治疗，合理方案为，
大三阳DNA定量高用替诺，
小三阳用恩替。

StephenW

回复 TRUMPHILARY 的帖子

慢性乙肝抗病毒治疗, 替诺和恩替长期疗效同样好.
大三阳DNA定量高用替诺可能会更好.