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| Antiviral effect of Entecavir versus Tenofovir Disoproxil Fumarate in the treatment of chronic hepatitis B and liver cirrhosis |
| SHEN Enhua WANG Moli WANG Lihong LI Xinshan YUAN Yimeng CHEN Peng YUAN Jing ZHANG Jingfen FU Guangshuang▲ |
| Department of Infection Disease, the FAW General Hospital, Jilin Province, Changchun 130011, China |
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Abstract Objective To compare the antiviral effect of Entecavir (ETV) and Tenofovir Disoproxil Fumarate (TDF) in initial treatment patients with chronic hepatitis B and liver cirrhosis. Methods A total of 80 initial treatment patients with chronic hepatitis B and liver cirrhosis who received antiviral therapy with TDF or ETV and were regularly followed up in the FAW General Hospital, from January 2016 to January 2017 were enrolled, and 38 patients were treated with TDF (TDF group) and 42 patients were treated with ETV (ETV group). Laboratory markers were measured before and at 24th, 36th, and 48th week of treatment, including liver and renal function parameters, serum calcium, serum phosphate, creatine kinase, HBV DNA level, hepatitis markers. Adverse drug reactions were also observed. Results At 24th week of treatment, HBsAg of ETV group was lower than that of TDF group (P ＜ 0.05). At 36th, 48th week of treatment, there was no difference in HBsAg of the two groups (P ＞ 0.05). At 24th, 36th, 48th week of treatment, the two groups had no statistical difference in ALT level (P ＞ 0.05). At 24th, 36th week of treatment, HBV DNA level of ETV group was lower than that of TDF group (P ＜ 0.05). At 48th week of treatment, HBV DNA level, proportion of HBeAg positive patients with HBV DNA level below floor level, rate of HBeAg turning negative, rate of HBeAg negative and positive patients with ALT turning normal in the two groups had no statistically difference (P ＞ 0.05). In TDF group, 2 cases occured serum inorganic phosphorus declined slightly, and bone mineral density was detected mild osteoporosi. Conclusion At 24th and 36th week of treatment, ETV restrains HBV DNA better than TDF, while at 48th week there is no differece between the two drugs.
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[1] 中华医学会肝病学分会，中华医学会感染病学分会.慢性乙型肝炎防治指南（2015年版）[J].中华实验和临床感染病杂志：电子版，2015，9（5）：570-589.
[2] 张文娟，张静洁，郑志兵.乙肝治疗新药—替诺福韦艾拉酚胺半富马酸[J].临床药物治疗杂志，2017，15（3）：10-13.
[3] Chan HL，Thompson A，Martinot-Peignoux M，et al. Hepatitis B surface antigen quantification：why and how to use it in 2011-a core group report [J]. J Hepatol，2011，55（5）：1121-1131.
[4] Grossi G，Viganò M，Loglio A，et al. Hepatitis B virus long-term impact of antiviral therapy nucleot（s）ide analogues（NUCs）[J]. Liver Int，2017，37（Suppl 1）：45-51.
[5] 樊蓉，孙剑，侯金林.慢性乙型肝炎抗病毒治疗现状及展望[J].临床肝胆病杂志，2016，32（11）：2029 -2032.
[6] Ha NB，Trinh HN，Rosenblatt L，et al. Treatment outcomes with first-line therapies with entecavir and tenofovir in treatmentnaive chronic hepatitis B patients in a routine clinical practice [J]. J Clin Gastroenterol，2016，50（2）：169-174.
[7] Idilman R，Gunsar F，Koruk M，et al. Long-term entecavir or tenofovir disoproxil fumarate therapy in treatment-na?觙ve chronic hepatitis B patients in the real- world setting [J]. J Viral Hepat，2015，22（5）：504-510.
[8] Yoo EH，Cho HJ. Clinical response to long- term tenofovir monotherapy in Korean chronic hepatitis B patients [J]. Clin Chim Acta，2017，471（8）：308-313.
[9] Murat K，Fatma S，Yesim A，et al. Head-to-head comparison of two years efficacy of entecavir and tenofovir in patients with treatment-naive chronic hepatitis B--The real life data [J]. Hepatogastroenterology，2015，62（140）：982-986.
[10] 张家伟，耿家宝，卢锋，等.富马酸替诺福韦酯二吡呋酯和恩替卡韦初治慢性HBV感染者的效果比较[J].临床肝胆病杂志，2018，34（2）：272-275.
[11] Arends P，Sonneveld MJ，Zoutendijk R，et al. Entecavir treatment does not eliminate the risk of hepatocellular carcinoma in chronic hepatitis B：limited role forrisk scores in Caucasians [J]. Gut，2015，64（8）：1289-1295.
[12] Petersen J，Heyne R，Mauss S，et al. Effectiveness and safety of tenofovir disoproxil fumarate in chronic hepatitis B：a 3-year prospective field practice study in Germany [J]. Dig Dis Sci，2016，61（10）：3061-3071.
[13] Tabernero D，Sánchez-Tapias JM，Calleja JL，et al. Long-term efficacy of tenofovir in previously treated and na?觙ve patients. Results from the Spanish Chronic Hepatitis B Registry（CIBERHEP）[J]. J Hepatol，2014，60（1）：S429.
[14] Marcellin P，Zoulim F，Hézode C. Effectiveness and safety of tenofovir disoproxil fumarate in chronic hepatitis B：a 3-year，prospective，realworld study in France [J]. Dig Dis Sci，2016，61（10）：3072-3083.
[15] Manfredi R，Calza L，Chiodo F. Efavirenz versus nevirapine in current clinical practice：a prospective，open-label observational study [J]. J Acquir Immune Defic Syndr，2004，35（5）：492-502.
[16] 武建国.HBsAg与HBV DNA定量的临床信息互补[J].临床检验杂志，2013，31（11）：801-804.
[17] Chan HL，Wong VW，Tse AM，et al. Serum hepatitis B surface antigen quantitation can reflect hepatitis B virus in the liver and predict treatment response [J]. Clin Gastroenterol Hepatol，2007，5（12）：1462-1468.
[18] 李韦杰，李伯安，赵景民，等.54例慢性乙型肝炎患者肝组织乙型肝炎病毒共价闭合环状DNA与血清HBsAg定量检测结果分析[J].中华肝脏病杂志，2011，19（11）：815-817.
[19] 汝琳.HBV核心相关抗原替代共价闭合环状DNA成为一种新的标志物[J].临床肝胆病杂志，2017，33（3）：587.
[20] Brunetto MR，Moriconi F，Bononi F，et al. HBsAg levels：a guide to sutained response to peginterferon alfa-2a in HBeAg-negative chronic hepatitis B [J]. Hepatology，2009，49（4）：1141-1150.
[21] 陶军秀，李晓东，曹婷，等.恩替卡韦治疗HBeAg阴性慢性乙型肝炎患者的依从性调查[J].临床肝胆病杂志，2017，33（8）：1558-1560.
[22] 余雪平，郭如意，柯邵鹏，等.慢性乙型肝炎及其肝硬化患者HBsAg与HBV DNA定量变化及其相关性[J].南方医科大学学报，2015，35（5）：682-686. |
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