Efficacy and safety of tenofovir alafenamide fumarate in treatment of chronic hepatitis B patients aged ≥60 years in Qingdao, China
10.3969/j.issn.1001-5256.2023.05.010
- VernacularTitle:富马酸丙酚替诺福韦治疗青岛地区60岁及以上慢性乙型肝炎患者的有效性和安全性
- Author:
Yuwen SONG
1
;
Lizhen CHEN
1
;
Wenwen JIN
1
;
Ning GENG
1
;
Yang ZHANG
1
;
Shuixian DU
1
;
Bentian ZHAO
1
;
Jianping DUAN
2
;
Yong ZHOU
2
;
Chunhua BI
3
;
Lei MA
4
;
Xinxin HU
4
;
Jihong ZHANG
5
;
Jiantao SUN
5
;
Jie TAN
1
;
Yongning XIN
1
Author Information
1. Department of Infectious Diseases, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong 266000, China
2. Department of Infectious Diseases, Qingdao Sixth People's Hospital, Qingdao, Shandong 266000, China
3. Department of Infectious Diseases, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China
4. Department of Infectious Diseases, Chengyang People's Hospital, Qingdao, Shandong 266000, China
5. Department of Infectious Diseases, Jimo People's Hospital, Qingdao, Shandong 266000, China
- Publication Type:Original Article_Viral Hepatitis
- Keywords:
Hepatitis B, Chronic;
Tenofovir Alafenemide Fumarate;
Treatment Outcome;
Aged
- From:
Journal of Clinical Hepatology
2023;39(5):1061-1069
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the application value of tenofovir alafenamide fumarate (TAF) in elderly patients with chronic hepatitis B (CHB) and its influence on bones and kidneys. Methods A total of 36 CHB patients, aged ≥60 years, who received TAF antiviral therapy in Qingdao Municipal Hospital, The Affiliated Hospital of Qingdao University, Qingdao Sixth People's Hospital, Chengyang People's Hospital, and Jimo People's Hospital from June 2021 to October 2022 were enrolled in this study, and all patients received TAF (25 mg/d) antiviral therapy. Related data were collected at baseline and weeks 24 and 48 of treatment, including virological indicators, biochemical parameters, urinary protein electrophoresis indices, transient elastography (FibroScan), and bone mineral density. Virological indicators included high-sensitivity HBV DNA quantification; biochemical parameters included total bilirubin, direct bilirubin (DBil), indirect bilirubin (IBil), alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase, total bile acid (TBA), glucose, blood urea nitrogen, creatinine, estimated glomerular filtration rate, and cystatin C (Cys C); urinary protein electrophoresis indices included urinary β2 microglobulin (β2-MG), urinary retinol (URBP), and urinary α1 microspherin (α1-MG). The paired t -test was used for comparison of normally distributed continuous data before and after treatment, and the Wilcoxon signed-rank test was used for comparison of non-normally distributed continuous data before and after treatment; the chi-square test or the Fisher's exact test was used for comparison of categorical data. Results A total of 36 CHB patients completed 24 weeks of follow-up. The complete virological response rate after 24 weeks of treatment was higher than that at baseline [83.3% (30/36) vs 77.8% (28/36), χ 2 =0.36, P =0.55], and there were significant reductions in DBil ( t =-2.42, P =0.02) and Cys C ( t =-4.34, P < 0.001) from baseline to week 24. A total of 18 CHB patients completed 48 weeks of follow-up. The complete virological response rate after 48 weeks of treatment was higher than that at baseline (94.4% vs 77.8%, χ 2 =2.22, P =0.34), and there were significant increases in IBil ( t =2.43, P =0.03), TBA ( Z =-2.24, P =0.03), and bone mineral density T score of lumbar vertebra ( t =2.92, P = 0.01) and femoral neck ( t =2.42, P =0.03) and a significant reduction in liver stiffness measurement ( t =-2.31, P =0.03). There were no significant changes in β2-MG, URBP, and α1-MG after treatment (all P > 0.05). Conclusion TAF has a good antiviral effect in CHB patients aged ≥60 years and can help more CHB patients achieve complete virological response, without causing damage to the kidney, and it can also improve bone mineral density and liver fibrosis degree.
