Clinical effect of tenofovir alafenamide fumarate on chronic hepatitis B patients with low viral load after entecavir treatment
10.3969/j.issn.1001-5256.2022.03.009
- VernacularTitle:富马酸丙酚替诺福韦对恩替卡韦经治后低病毒载量的慢性乙型肝炎患者的临床疗效
- Author:
Hailin CHENG
1
;
Xudong HU
1
;
Bing XIA
1
;
Tao BAI
1
;
Sixia LU
1
Author Information
1. Department of Gastroenterology, Wuhan Jinyintan Hospital, Wuhan 430023, China
- Publication Type:Original Articles_Viral hepatitis
- Keywords:
Hepatitis B, Chronic;
Low-Level Viremia;
Entecavir;
Propofol Tenofavir Fumarate
- From:
Journal of Clinical Hepatology
2022;38(3):537-540
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical effect of tenofovir alafenamide fumarate (TAF) on chronic hepatitis B (CHB) patients with low-level viremia (LLV) after entecavir (ETV) treatment. Methods A total of 160 CHB patients who received ETV antiviral therapy in Wuhan Jinyintan Hospital from March 2019 to October 2020 were enrolled and divided into experimental group and control group by propensity score matching, with 80 patients in each group. The patients in the experimental group were given TAF antiviral therapy, and those in the control group were given ETV treatment; the course of treatment was 24 weeks for both groups. The two groups were compared in terms of HBV-DNA clearance rate, HBeAg clearance rate, alanine aminotransferase (ALT) level, estimated glomerular filtration rate (eGFR), FIB-4 value, liver stiffness measurement, and adverse drug reactions after treatment. The t -test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. Results After 24 weeks of treatment, compared with the control group, the experimental group had significantly higher HBV DNA clearance rate (96.25% vs 16.25%, χ 2 =104.03, P < 0.001) and HBeAg clearance rate (34.78% vs 11.90%, χ 2 =6.32, P < 0.05). Compared with the control group, the experimental group had varying degrees of improvement in ALT, eGFR, FIB-4, and liver stiffness measurement ( t =5.77, 4.21, 8.45, and 4.58, all P < 0.05), and there was no significant difference in the incidence rate of adverse drug reactions between the control group and the experimental group during treatment (7.50% vs 8.75%, P > 0.05). Conclusion For CHB patients with LLV after ETV treatment, the change to TAF antiviral therapy can effectively increase their HBV DNA clearance rate and HBeAg clearance rate, improve liver and renal function, and reduce the degree of liver fibrosis, with good safety.
