中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 3
Mar.  2022
Turn off MathJax
Article Contents

Clinical effect of tenofovir alafenamide fumarate on chronic hepatitis B patients with low viral load after entecavir treatment

DOI: 10.3969/j.issn.1001-5256.2022.03.009
Research funding:

Scientific Research Project of Wuhan Health and Family Planning Commission (WX17D19)

More Information
  • Corresponding author: CHENG hailin, 22758091@qq.com(ORCID:0000-0003-2720-4444)
  • Received Date: 2021-06-07
  • Accepted Date: 2021-07-22
  • Published Date: 2022-03-20
  •   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%, χ2 =104.03, P < 0.001) and HBeAg clearance rate (34.78% vs 11.90%, χ2=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.

     

  • loading
  • [1]
    KIM JH, SINN DH, KANG W, et al. Low-level viremia and the increased risk of hepatocellular carcinoma in patients receiving entecavir treatment[J]. Hepatology, 2017, 66(2): 335-343. DOI: 10.1002/hep.289.16.
    [2]
    TERRAULT NA, LOK A, MCMAHON BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance[J]. Hepatology, 2018, 67(4): 1560-1599. DOI: 10.1002/hep.29800.
    [3]
    SUN Y, WU X, ZHOU J, et al. Persistent low level of hepatitis B irus promotes fibrosis progression during therapy[J]. Clin Gastroenterol Hepatol, 2020, 18(11): 2582-2591. DOI: 10.1016/j.cgh.2020.03.001.
    [4]
    MAK LY, HUANG Q, WONG DK, et al. Residual HBV DNA and pgRNA viraemia is associated with hepatocellular carcinoma in chronic hepatitis B patients on antiviral therapy[J]. J Gastroenterol, 2021, 56(5): 479-488. DOI: 10.1007/s00535-021-01780-5.
    [5]
    KIM SS, HWANG JC, LIM SG, et al. Effect of virological response to entecavir on the development of hepatocellular carcinoma in hepatitis B viral cirrhotic patients: Comparison between compensated and decompensated cirrhosis[J]. Am J Gastroenterol, 2014, 109(8): 1223-1233. DOI: 10.1038/ajg.2014.145.
    [6]
    LI ZB, LI L, NIU XX, et al. Switching from entecavir to tenofovir alafenamide for chronic hepatitis B patients with low-level viraemia[J]. Liver Int, 2021, 41(6): 1254-1264. DOI: 10.1111/liv.14786.
    [7]
    Chinese Society of Infectious Diseases, Chinese Medical Association; Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B (version 2019)[J]. J Clin Hepatol, 2019, 35(12): 2648-2669. DOI: 10.3969 /j.Issn.1001-5256.2019.12.007.

    中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35(12): 2648-2669. DOI: 10.3969 /j.Issn.1001-5256.2019.12.007.
    [8]
    YIM HJ, KIM IH, SUH SJ, et al. Switching to tenofovir vs continuing entecavir for hepatitis B virus with partial virologic response to entecavir: A randomized controlled trial[J]. J Viral Hepat, 2018, 25(11): 1321-1330. DOI: 10.1111/jvh.12934.
    [9]
    WANG YH, LIAO J, ZHANG DM, et al. Tenofovir monotherapy versus tenofovir plus entecavir combination therapy in HBeAg-positive chronic hepatitis patients with partial virological response to entecavir[J]. J Med Virol, 2020, 92(3): 302-308. DOI: 10.1002/jmv.25608.
    [10]
    HU P, SHANG J, ZHANG WH, et al. HBsAg loss with pegylated-interferon alfa-2a in hepatitis B patients with partial response to nucleos(t)ide analog: New switch study[J]. Chin J Hepatol, 2018, 26(10): 756-764. DOI: 10. 3760/cma. j.issn.1007-3418.2018.10.005.
    [11]
    MURAKAMI E, WANG T, PARK Y, et al. Implications of efficient hepatic delivery by tenofovir alafenamide (GS-7340) for hepatitis B virus therapy[J]. Antimicrob Agents Chemother, 2015, 59(6): 3563-3569. DOI: 10.1128/AAC.00128-15.
    [12]
    LU JF, HOU W, MA LN, et al. Early antiviral efficacy of tenofovir alafenamide fumarate in initial treatment of patients with chronic hepatitis B}[J/CD]. Chin J Liver Dis (Electronic Version), 2020, 12(3): 29-33. DOI: 10.3969/j.issn.1674-7380.2020.03.006.

    鲁俊锋, 侯维, 马丽娜, 等. 富马酸丙酚替诺福韦初始治疗慢性乙型肝炎患者的早期疗效[J/CD]. 中国肝脏病杂志(电子版), 2020, 12(3): 29-33. DOI: 10.3969/j.issn.1674-7380.2020.03.006.
    [13]
    ZHANG JW, GENG JB, LU F, et al. Clinical effect of tenofovir disoproxil fumarate versus entecavir in treatment of treatment-naive patients with chronic HBV infection[J]. J Clin Hepatol, 2018, 34(2): 272-275. DOI: 10.3969/j.issn.1001-5256.2018.02.011.

    张家伟, 耿家宝, 卢锋, 等. 富马酸替诺福韦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. DOI: 10.3969/j.issn.1001-5256.2018.02.011.
    [14]
    FU GS, SHEN EH, WANG ML, et al. Effect comparison of Entecavir and Tenofovir Disoproxil Fumarate in the treatment of chronic hepatitis B and liver cirrhosis[J]. China Med Herald, 2021, 18(35): 121-124. https://www.cnki.com.cn/Article/CJFDTOTAL-HAIX202005040.htm

    付广双, 申恩华, 王茉莉, 等. 恩替卡韦、富马酸替诺福韦二吡夫酯片治疗慢性乙型肝炎及其肝硬化的效果比较[J]. 中国医药导报, 2021, 18(35): 121-124. https://www.cnki.com.cn/Article/CJFDTOTAL-HAIX202005040.htm
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(3)

    Article Metrics

    Article views (1294) PDF downloads(126) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return