恩替卡韦和替诺福韦对乙型肝炎病毒相关补偿和解除肝硬化

StephenW

Gut Liver. 2017 Jun 27. doi: 10.5009/gnl16484. [Epub ahead of print]
Effects of Entecavir and Tenofovir on Renal Function in Patients with Hepatitis B Virus-Related Compensated and Decompensated Cirrhosis.Park J1, Jung KS1, Lee HW1,2, Kim BK1,3,2, Kim SU1,3,2, Kim DY1,3,2, Ahn SH1,3,2, Han KH1,3,2, Park JY1,3,2.
Author information
1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.2Yonsei Liver Center, Yonsei University Health System, Seoul, Korea.3Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.

AbstractBackground/Aims: The renal effects of nucleos(t)ide analogs in patients with chronic hepatitis B are controversial. We aimed to compare the impact of entecavir (ETV) and tenofovir (TDF) on renal function in patients with hepatitis B virus (HBV)-related cirrhosis.
Methods: We performed a retrospective cohort study of 235 consecutive treatment-naïve patients with HBV-related cirrhosis who were treated with ETV or TDF between December 2012 and November 2013 at Severance Hospital, Seoul, Korea.
Results: Compensated cirrhosis was noted in 183 patients (ETV 130, TDF 53), and decompensated cirrhosis was noted in 52 patients (ETV 32, TDF 20). There were no significant changes in estimated glomerular filtration rates (eGFR) from baseline in either the ETV- or TDF-treated groups at week 96 (CKD-EPI, ETV -1.68% and TDF -5.03%, p=0.358). Using a multivariate analysis, the significant factors associated with a decrease in eGFR >20% were baseline eGFR, diabetes mellitus (DM), and the use of diuretics. The use of antiviral agents and baseline decompensation were not determined to be significant factors.
Conclusions: In patients with HBV-related cirrhosis, TDF has shown similar renal safety to that of ETV over a two year period. Renal function should be closely monitored, especially in patients who exhibit decreasing eGFR, DM, and the use of diuretics.


KEYWORDS: Entecavir; Fibrosis; Hepatitis B; Renal safety; Tenofovir

StephenW

肠肝2017年6月27日。doi：10.5009 / gnl16484。 [提前印刷]
恩替卡韦和替诺福韦对乙型肝炎病毒相关补偿和解除肝硬化患者肾功能的影响。
Park J1，Jung KS1，Lee HW1,2，Kim BK1,3,2，Kim SU1,3,2，Kim DY1,3,2，Ahn SH1,3,2，Han KH1,3,2，Park JY1,3 ，2。
作者信息

1
    延世大学医学院内科系，韩国首尔。
2
    延世大学健康系统延世中心，韩国首尔。
3
    延世大学医学院胃肠病研究所，首尔，韩国。

抽象
背景/目的：

慢性乙型肝炎患者核苷类似物的肾脏效应是有争议的。我们旨在比较恩替卡韦（ETV）和替诺福韦（TDF）对乙型肝炎病毒（HBV）相关性肝硬化患者肾功能的影响。
方法：

我们对2012年12月至2013年11月在韩国首尔Severance医院接受ETV或TDF治疗的235例接受治疗的HBV相关性肝硬化患者进行了回顾性队列研究。
结果：

在183例患者（ETV 130，TDF 53）中注意到补偿性肝硬化，52例患者（ETV 32，TDF 20）发现失代偿性肝硬化。在第96周时，ETV或TDF治疗组的基线估计肾小球滤过率（eGFR）没有显着变化（CKD-EPI，ETV-1.68％和TDF -5.03％，p = 0.358）。使用多变量分析，与eGFR> 20％相关的重要因素是基线eGFR，糖尿病（DM）和利尿剂的使用。使用抗病毒药物和基线代偿失调未被确定为重要因素。
结论：

在HBV相关性肝硬化患者中，TDF在两年内显示与ETV相似的肾脏安全性。应密切监测肾功能，特别是在出现eGFR，DM和使用利尿剂的患者中。
关键词：

恩替卡韦;纤维化;乙型肝炎肾脏安全;替诺福韦

StephenW

http://www.gutnliver.org/journal/view.html?doi=10.5009/gnl16484