替诺福韦单药治疗慢性乙型肝炎患儿的抗病毒疗效

StephenW

J Korean Med Sci. 2018 Jan 8;33(2):e11. doi: 10.3346/jkms.2018.33.e11.
Antiviral Efficacy of Tenofovir Monotherapy in Children with Nucleos(t)ide-naive Chronic Hepatitis B.Choe JY#1, Ko JS#2, Choe BH3, Kim JE1, Kang B1, Lee KJ2, Yang HR2.
Author information
1Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea.2Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.3Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea. [email protected].#Contributed equally

AbstractBACKGROUND: The purpose was to compare the efficacy between tenofovir disoproxil fumarate (TDF) and lamivudine (LMV) in children with nucleos(t)ide-naive chronic hepatitis B (CHB) infection. Patients with CHB were treated with TDF in the immune-reactive phase and compared with a historical control group of patients treated with LMV before the TDF era.
METHODS: Hepatitis B virus (HBV) DNA titer decrements (> 3 log₁₀ IU/mL) were monitored after treatment initiation. The treatment duration for HBV DNA clearance (< 357 IU/mL) and complete response (HBeAg loss and HBV DNA clearance) were analyzed. The follow-up period was 96 weeks.
RESULTS: Sixteen patients were treated with TDF and compared with a historical control group of 24 patients treated with LMV. HBV DNA decrement (> 3 log₁₀ IU/mL) was achieved in 100% (16/16) of the TDF group but in only 62.5% (15/24) of the LMV group (P = 0.005) at 48 weeks. The HBV DNA clearance (< 357 IU/mL) in the TDF and LMV groups was, respectively, as follows: 62.5% (10/16) and 25.0% (6/24) at 12 weeks (P = 0.018), 81.3% (13/16) and 37.5% (9/24) at 24 weeks (P = 0.006), 93.8% (15/16) and 50.0% (12/24) at 48 weeks (P = 0.004), and 100% (16/16) and 54.2% (13/24) at 96 weeks (P = 0.001). Complete response occurred in 41.7% (5/12) of HBeAg-positive patients in the TDF group and 28.6% (6/21) of the LMV group at 96 weeks (P = 0.443).
CONCLUSION: TDF monotherapy for 96 weeks produced a significantly more effective virologic response than LMV monotherapy in children with nucleos(t)ide-naive CHB.

StephenW

J Korean Med Sci。 2018年1月8日; 33（2）：e11。 Doi：10.3346 / jkms.2018.33.e11。
替诺福韦单药治疗慢性乙型肝炎患儿的抗病毒疗效
Choe JY＃1，Ko JS＃2，Choe BH3，Kim JE1，Kang B1，Lee KJ2，Yang HR2。
作者信息

1
韩国大邱庆北大学医学部小儿科。
2
首尔大学医学院小儿科，韩国首尔。
3
韩国大邱庆北大学医学部小儿科。 [email protected]。
＃
贡献平等

抽象
背景：

目的是比较替诺福韦酯替诺福韦（TDF）和拉米夫定（LMV）在核苷（天）慢性乙型肝炎（CHB）感染儿童的疗效。 CHB患者在免疫反应阶段用TDF治疗，并与TDF时代之前用LMV治疗的患者的历史对照组进行比较。
方法：

分析HBV DNA清除（<357 IU / mL）和完全缓解（HBeAg消失和HBV DNA清除）的治疗时间。随访时间为96周。
结果：

用TDF治疗16例患者，并与24例接受LMV治疗的患者的历史对照组进行比较。在TDF组中，100％（16/16）组HBV DNA减少（> 3 log 10 IU / mL），而TDF组和LMV组HBV DNA清除率（<357 IU / mL）仅为62.5％分别为：第12周（P = 0.018）62.5％（10/16）和25.0％（6/24），24周时分别为81.3％（13/16）和37.5％（9/24） 0.006）（12/24），96周时（P = 0.004）和100％（16/16）和54.2％（13/24）。 TDF组中有41.7％（5/12）的HBeAg阳性患者完全缓解，96周时LMV组中有28.6％（6/21）（P = 0.443）。
结论：

TDF单药治疗96周产生病毒学反应明显比LMV单药治疗儿童无核苷（天）CHB CHB

StephenW

https://jkms.org/DOIx.php?id=10.3346/jkms.2018.33.e11