恩替卡韦或替诺福韦停药后替诺福韦艾拉酚胺、恩替卡韦和

StephenW

恩替卡韦或替诺福韦停药后替诺福韦艾拉酚胺、恩替卡韦和富马酸替诺福韦二吡呋酯的复治疗效和肾脏安全性
Shao-Ming Chiu 1 , Kuo-Chin Chang 1 , Tsung-Hui Hu 1 , Chao-Hung 1 , Jing-Houng Wang 1 , Sheng-Nan Lu 1 , Chien-Hung Chen 2
隶属关系
隶属关系

    1
    台湾高雄市打培路123号长庚大学医学院高雄长庚纪念医院内科肝肠内科。
    2
    台湾高雄市打培路123号长庚大学医学院高雄长庚纪念医院内科肝肠内科。 [email protected]。

    PMID：35976597 DOI：10.1007/s10620-022-07657-8

抽象的

背景：我们旨在比较恩替卡韦、富马酸替诺福韦酯 (TDF) 和丙酚替诺福韦 (TAF) 在停用恩替卡韦或 TDF 的患者 HBV 复发后的一年再治疗疗效和肾脏安全性。

方法：这项回顾性研究包括 289 名无肝硬化的慢性乙型肝炎 (CHB) 患者，他们在恩替卡韦或 TDF 停用后接受恩替卡韦 (n = 93)、TDF (n = 103) 或 TAF (n = 86) 再治疗至少 12 个月.

结果：恩替卡韦组在复治 12 个月时的病毒学应答率（HBV DNA < 20 IU/mL）为 79/93（84.9%），TDF 组为 92/103（89.3%），72/86 (83.7%) 在 TAF 组中。复治 12 个月后 ALT 正常化率（ALT ≤ 40 U/L），恩替卡韦组为 76/93（81.7%），TDF 组为 77/103（74.7%），73/86（84.9%） ) 在 TAF 组中。三组病毒学应答率（p = 0.495）和ALT正常化率（p = 0.198）无显着差异。多变量分析表明，基线时较低的 HBV DNA 和 HBsAg 水平与再治疗 12 个月时的病毒学应答独立相关。 TDF 组 (37.8 ± 34.8 U/L) 在再治疗 12 个月时的 ALT 水平高于 TAF (27. ± 17.9 U/L, p = 0.015) 和恩替卡韦 (28.3 ± 19.3 U/L, p = 0.022)团体。在 eGFR 为 60-90 mL/min/1.73 m2 的患者中，恩替卡韦和 TAF 组基线和复治 12 个月之间的 eGFR 变化增加，而 TDF 组减少。

结论：TAF 可能是恩替卡韦或 TDF 停用后 HBV 复发再治疗的再治疗选择之一。

关键词：恩替卡韦；乙型肝炎表面抗原；乙型肝炎病毒;替诺福韦艾拉酚胺；富马酸替诺福韦酯。

© 2022。作者获得 Springer Science+Business Media, LLC 的独家许可，该公司隶属于 Springer Nature。

StephenW

Retreatment Efficacy and Renal Safety of Tenofovir Alafenamide, Entecavir, and Tenofovir Disoproxil Fumarate After Entecavir or Tenofovir Cessation
Shao-Ming Chiu  1 , Kuo-Chin Chang  1 , Tsung-Hui Hu  1 , Chao-Hung Hung  1 , Jing-Houng Wang  1 , Sheng-Nan Lu  1 , Chien-Hung Chen  2
Affiliations
Affiliations

    1
    Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta Pei Road, Kaohsiung, Taiwan.
    2
    Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta Pei Road, Kaohsiung, Taiwan. [email protected].

    PMID: 35976597 DOI: 10.1007/s10620-022-07657-8

Abstract

Background: We aimed to compare the one-year retreatment efficacy and renal safety of entecavir, tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide (TAF) after HBV relapse in patients who discontinued entecavir or TDF.

Methods: This retrospective study included 289 chronic hepatitis B (CHB) patients without cirrhosis who received entecavir (n = 93), TDF (n = 103), or TAF (n = 86) retreatment for at least 12 months after entecavir or TDF cessation.

Results: The rate of virological response (HBV DNA < 20 IU/mL) at 12 months of retreatment was 79/93 (84.9%) in the entecavir group, 92/103 (89.3%) in the TDF group, and 72/86 (83.7%) in the TAF group. The rate of ALT normalization (ALT ≤ 40 U/L) after 12 months of retreatment was 76/93 (81.7%) in the entecavir group, 77/103 (74.7%) in the TDF group , and 73/86 (84.9%) in the TAF group. There was no significant difference in the rates of virological response (p = 0.495) and ALT normalization (p = 0.198) among the three groups. Multivariate analysis showed that lower HBV DNA and HBsAg levels at baseline were independently associated with virological response at 12 months of retreatment. The TDF group (37.8 ± 34.8 U/L) had higher ALT levels at 12 months of retreatment than the TAF (27. ± 17.9 U/L, p = 0.015) and entecavir (28.3 ± 19.3 U/L, p = 0.022) groups. In patients with eGFR 60-90 mL/min/1.73 m2, eGFR change between baseline and 12 months of retreatment increased in the entecavir and TAF groups and decreased in the TDF group.

Conclusions: TAF could be one of the retreatment options for retreatment of HBV relapse after entecavir or TDF cessation.

Keywords: Entecavir; Hepatitis B surface antigen; Hepatitis B virus; Tenofovir alafenamide; Tenofovir disoproxil fumarate.

© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.