最佳的给药方式可以挽救恩替卡韦或替诺福韦治疗慢性乙型

StephenW

J Viral Hepat. 2020 Feb 11. doi: 10.1111/jvh.13275. [Epub ahead of print]
Optimal drug administration manner would rescue partial virological response in chronic hepatitis B patients with entecavir or tenofovir treatment.
Tao YC1,2, Wang ML1,2, Zhang DM1,2, Wu DB1,2, Wang YH1,2, Liao J1,2, Tang H1,2, Chen EQ1,2.
Author information

1
    Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, 610041, P.R. China.
2
    Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University, Chengdu, Sichuan, 610041, PR China.

Abstract

Not all treatment-naïve patients receiving entecavir (ETV) or tenofovir disoproxil fumarate (TDF) therapy can achieve complete virological response, and many factors may be related with the outcome of partial virological response. This study aimed to determine whether the manner of drug administration affects the antiviral efficacy of ETV/TDF monotherapy. All eligible patients were divided into complete or partical response cohorts based on their virological response following 24-weeks therapy. Factors related with partial response were evaluated. Patients with partial response were further grouped depending on whether they later adjusted the manner of drug administration, and the antiviral efficacy was compared between the two groups during prolonged treatment. A total of 518 patients were enrolled. Suboptimal drug administration (OR 77.511, p =0.000), positive-HBeAg (OR 3.191, p =0.000) and ETV treatment (OR 2.537, p =0.001) were identified as independent risk factors for partial response. Among patients with partial response, 213 were in the adjusted group and 76 were in the unadjusted group. The percentages of patients with undetectable serum HBV DNA (78.9% vs 31.6%, p <0.001) and with normal ALT (88.7% vs 68.4%, p <0.001) were both higher in the adjusted group than that in unadjusted group following a further 6-months therapy. In conclusion, the manner of drug administration is an important factor influencing the efficacy of ETV/TDF therapy, and optimal drug administration manner can help to increase antiviral efficacy and rescue patients with partial response.

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KEYWORDS:

Complete virological response; Drug administration manner; Entecavir; Partial virological response; Tenofovir

PMID:
    32048386
DOI:
    10.1111/jvh.13275

StephenW

J病毒性肝炎。 2020年2月11日。doi：10.1111 / jvh.13275。 [Epub提前发行]
最佳的给药方式可以挽救恩替卡韦或替诺福韦治疗慢性乙型肝炎患者的部分病毒学应答。
陶YC1,2，王ML1,2，张DM1,2，吴DB1,2，王YH1,2，廖J1,2，唐H1,2，陈EQ1,2。
作者信息

1个
    四川大学华西医院传染病研究中心，成都610041
2
    四川大学传染病科，生物治疗国家重点实验室，四川成都610041。

抽象

并非所有接受恩替卡韦（ETV）或替诺福韦富马酸替诺福韦（TDF）治疗的初治患者都不能达到完全的病毒学应答，许多因素可能与部分病毒学应答的结果有关。这项研究旨在确定药物的给药方式是否会影响ETV / TDF单一疗法的抗病毒功效。根据24周治疗后的病毒学应答，将所有符合条件的患者分为完全应答或部分应答队列。评估与部分反应相关的因素。有部分反应的患者根据以后是否调整药物给药方式进一步分组，并在长期治疗期间比较两组的抗病毒效力。共有518名患者入组。不理想的药物管理（OR 77.511，p = 0.000），HBeAg阳性（OR 3.191，p = 0.000）和ETV治疗（OR 2.537，p = 0.001）被确定为部分反应的独立危险因素。在部分缓解的患者中，调整组为213名，未调整组为76名。进一步调整后，调整组的血清HBV DNA检测不到的患者（78.9％vs 31.6％，p <0.001）和ALT正常的患者（88.7％vs 68.4％，p <0.001）的百分比均高于未调整组。 6个月的治疗。综上所述，药物的给药方式是影响ETV / TDF治疗效果的重要因素，最佳的药物给药方式可以提高抗病毒药效，挽救部分反应的患者。

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关键字：

完全的病毒学反应；给药方式；恩替卡韦;部分病毒学应答；替诺福韦

PMID：
    32048386
DOI：
    10.1111 / jvh.13275