与恩替卡韦核仁（t）ide类似物治疗慢性乙型肝炎携带者相比

StephenW

Aliment Pharmacol Ther. 2017 Jul 13. doi: 10.1111/apt.14218. [Epub ahead of print]
Tenofovir disoproxil fumarate significantly decreases serum lipoprotein levels compared with entecavir nucleos(t)ide analogue therapy in chronic hepatitis B carriers.Shaheen AA1, AlMattooq M1, Yazdanfar S1, Burak KW1, Swain MG1, Congly SE1, Borman MA1, Lee SS1, Myers RP1, Coffin CS1.
Author information
1Calgary Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.

AbstractBACKGROUND: Tenofovir disoproxil fumarate (TDF) and entecavir (ETV) are first-line treatments for chronic hepatitis B (CHB). Studies suggest lipid lowering effect of TDF in human immunodeficiency virus positive (HIV+) individuals, but the effect on lipids and cardiovascular disease (CVD) risk in CHB is unknown.
AIM: To compare TDF vs ETV effects on lipid levels in CHB.
METHODS: In this retrospective cohort study, data on serum lipids and CVD risk factors at baseline and ~1 year on TDF or ETV were collected from CHB carriers. We used propensity score matched models to assess the effect on total cholesterol (TC), LDL-C, HDL and triglycerides (TGL).
RESULTS: In 348 patients, median age was 57 (IQR: 47-65 years), 63% were male, 77% were Asian, 19% were cirrhotic, 25% were HBeAg positive at baseline, and 72% received TDF vs 28% ETV. ETV-treated patients were older (median age: 60 vs 55, P<.01), had similar smoking and hypertension rates, but diabetes and dyslipidemia were more prevalent (19% vs 9%, P=.01; 14% vs 6%, P=.05, respectively). In propensity score matched models for age, gender, usage of lipid lowering agents, dyslipidemia and diabetes, TDF-treated patients were more likely to show a 20% decrease in TC (95% CI: 3%-25%), LDL-C (95% CI: 1%-25%) and HDL-C (CI: 10%-30%) levels compared with those on ETV. No change in TGL was observed in either group.
CONCLUSIONS: A greater decline in TC, LDL-C and HDL was observed in CHB carriers receiving TDF compared with ETV. These data may influence anti-viral choice in CHB carriers at risk for CVD.

© 2017 John Wiley & Sons Ltd.

PMID:28707319DOI:10.1111/apt.14218

StephenW

药物治疗2017 Jul 13. doi：10.1111 / apt.14218。 [提前印刷]
与恩替卡韦核仁（t）ide类似物治疗慢性乙型肝炎携带者相比，替诺福韦地索普定富马酸盐显着降低血清脂蛋白水平。
Shaheen AA1，AlMattooq M1，Yazdanfar S1，Burak KW1，Swain MG1，Congly SE1，Borman MA1，Lee SS1，Myers RP1，Coffin CS1。
作者信息

1
    加拿大阿尔伯塔省卡尔加里卡尔加里康明大学医学系胃肠病学和肝脏病学系卡尔加里肝单位。

抽象
背景：

替诺福韦富地罗芬替莫夫（TDF）和恩替卡韦（ETV）是慢性乙型肝炎（CHB）的一线治疗。研究表明，TDF在人类免疫缺陷病毒阳性（HIV +）个体中的降脂作用，但对CHB对脂质和心血管疾病（CVD）风险的影响是未知的。
目标：

比较TDF与ETV对CHB脂质水平的影响。
方法：

在这项回顾性队列研究中，从CHB携带者收集了基线和TDF或ETV〜1年血清脂质和CVD危险因素的数据。我们使用倾向得分匹配模型来评估对总胆固醇（TC），LDL-C，HDL和甘油三酯（TGL）的影响。
结果：

348例患者中位年龄57岁（IQR：47-65岁），男性63例，亚洲77例，肝硬化19例，基线HBeAg阳性25例，占TDF占28％。经ETV治疗的患者年龄较大（中位年龄：60岁vs 55岁，P <0.01），吸烟和高血压相似，糖尿病和血脂异常更为普遍（19％vs 9％，P = 0.01; 14％vs 6 ％，P = 0.05）。在年龄，性别，降脂药物，血脂异常和糖尿病的倾向评分匹配模型中，TDF治疗的患者更有可能显示TC（95％CI：3％-25％），LDL-C （95％CI：1％-25％）和HDL-C（CI：10％-30％）水平。两组TGL均无变化。
结论：

与ETV相比，在接受TDF的CHB载体中观察到TC，LDL-C和HDL的下降更大。这些数据可能会影响患有CVD风险的CHB携带者的抗病毒选择。

©2017 John Wiley＆Sons Ltd.

结论：
    28707319
DOI：
    10.1111 / apt.14218