长期替诺福韦地索普西富马酸盐治疗慢性乙型肝炎患者实际

StephenW

Korean J Intern Med. 2019 Apr 8. doi: 10.3904/kjim.2019.037. [Epub ahead of print]
Efficacy of long-term tenofovir disoproxil fumarate therapy in chronic hepatitis B patients with partial virologic response in real practice.
Song JE1, Lee CH1, Kim BS1.
Author information

1
    Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea.

Abstract
Background/Aims:

The optimal management of chronic hepatitis B (CHB) patients with partial virologic response (PVR) to tenofovir disoproxil fumarate (TDF) remains unclear. We aimed to evaluate the long-term efficacy of prolonged TDF therapy in treatment-naïve CHB patients with PVR to TDF therapy in real practice.
Methods:

We retrospectively investigated the efficacy of prolonged TDF therapy in treatment-naïve CHB patients with PVR to TDF. PVR was defined as a decrease in serum hepatitis B virus (HBV) DNA over 2 log10 IU/mL from baseline, with detectable HBV DNA by real-time polymerase chain reaction at week 48.
Results:

We included 232 patients who underwent TDF therapy for over 48 weeks. Forty-two patients (18.1%) showed PVR. In multivariate analysis, hepatitis B e antigen (HBeAg) positivity, and high levels of serum HBV DNA at baseline and week 12 were independent predictive factors for PVR during TDF therapy. Out of 42 patients with PVR, 39 (92.9%) achieved virologic response (VR) during continuous TDF treatment; the cumulative VR rates at 24, 36, and 48 months were 79.8%, 88.2%, and 95.6%, respectively. With an additional 12 months of therapy, VR was achieved in 28/31 (90.3%) patients with HBV DNA < 100 IU/mL, compared to 5/11 (45.5%) patients with HBV DNA ≥ 100 IU/mL, at week 48.
Conclusions:

The vast majority of patients achieved VR through prolonged TDF therapy, thus TDF treatment can be maintained in nucleos(t)ide-naïve patients with PVR at week 48, especially in those with low viremia.
KEYWORDS:

Hepatitis B, chronic; Partial virologic response; Real practice; Tenofovir

PMID:
    30959583
DOI:
    10.3904/kjim.2019.037

StephenW

韩国J实习医生。 2019年4月8日。土井：10.3904 / kjim.2019.037。 [印刷前的电子版]
长期替诺福韦地索普西富马酸盐治疗慢性乙型肝炎患者实际部分病毒学应答的疗效。
Song JE1，Lee CH1，Kim BS1。
作者信息

1
韩国大邱大邱天主教大学内科学系。

抽象
背景/目的：

对替诺福韦地索普西富马酸盐（TDF）部分病毒学应答（PVR）的慢性乙型肝炎（CHB）患者的最佳治疗仍不清楚。我们的目的是在实际操作中评估长期TDF治疗对治疗初治CHB患者PVR至TDF治疗的长期疗效。
方法：

我们回顾性研究了长期TDF治疗对治疗初治CHB患者PVR治疗TDF的疗效。 PVR被定义为血清乙型肝炎病毒（HBV）DNA从基线开始减少超过2 log10 IU / mL，在第48周通过实时聚合酶链反应检测到HBV DNA。
结果：

我们纳入了232名接受TDF治疗超过48周的患者。 42名患者（18.1％）显示PVR。在多变量分析中，乙型肝炎e抗原（HBeAg）阳性，基线和第12周时血清HBV DNA水平高于42例PVR患者中，39例（92.9％）在连续TDF治疗期间达到病毒学应答（VR）; 24,36和48个月的累积VR率分别为79.8％，88.2％和95.6％。经过12个月的治疗，HBV DNA <100 IU / mL的28/31（90.3％）患者实现了VR，而HBV DNA≥100IU / mL的患者为5/11（45.5％） 48。
结论：

绝大多数患者通过延长TDF治疗达到VR，因此TDF治疗可在第48周时在未接受过PVR治疗的患者中维持，特别是在病毒血症较低的患者中。
关键词：

乙型肝炎，慢性;部分病毒学应答;真实的做法;替诺福韦

结论：
30959583
DOI：
10.3904 / kjim.2019.037