Background and Aims:The therapeutic effect of tenofovir alafenamide fumarate(TAF),tenofovir disoproxil fumarate(TDF)and entecavir(ETV)on chronic hepatitis B(CHB)patients remains inconsistent.The aim of this study was ...Background and Aims:The therapeutic effect of tenofovir alafenamide fumarate(TAF),tenofovir disoproxil fumarate(TDF)and entecavir(ETV)on chronic hepatitis B(CHB)patients remains inconsistent.The aim of this study was to explore the differences in virological responses to TAF,TDF and ETV in patients with CHB.Methods:Literature searches were conducted of the PubMed,EMBASE,and the Cochrane Library databases to identify randomized controlled trials and observational studies published up to July 21,2020.Statistical comparisons of virological response between TDF,ETV,and TAF were carried out with pooled odds ratio(OR)values.Results:The virological response in TDF-treated CHB patients was notably superior to that of the ETV-treated CHB patients after 12-weeks[OR=1.12,95%confidence interval(CI):0.89–1.41],24-weeks(OR=1.33,95%CI:1.11–1.61),48-weeks(OR=1.62,95%CI:1.16–2.25),72-weeks(OR=1.43,95%CI:0.78–2.62),and 96-weeks(OR=1.56,95%CI:0.87–2.81)treatment.No significant difference was observed for the virological responses in CHB patients after 48-weeks treatment with TAF or TDF.The virological response in TDF+ETV-treated CHB patients was superior to that of TDF-treated CHB patients after 24-weeks,48-weeks(OR=1.54,95%CI:1.17–2.02),96-weeks,and 144-weeks.Conclusions:The virological response in TDF-treated CHB patients was superior to that in ETV-treated CHB patients,but there was no significant difference between TAF and TDF.In addition,the therapeutic effect of TDF+ETV was superior to TDF alone.展开更多
目的:探究高乙型肝炎病毒载量妊娠中晚期孕妇使用替比夫定阻断乙型肝炎病毒(Hepatitis B virus,HBV)母婴传播的效果。方法:选取我院2018年7月至2020年10月期间收治的97例高乙型肝炎病毒载量妊娠中晚期孕妇作为研究对象,根据随机数字表...目的:探究高乙型肝炎病毒载量妊娠中晚期孕妇使用替比夫定阻断乙型肝炎病毒(Hepatitis B virus,HBV)母婴传播的效果。方法:选取我院2018年7月至2020年10月期间收治的97例高乙型肝炎病毒载量妊娠中晚期孕妇作为研究对象,根据随机数字表法分为DTF组(n=48)和LdT组(n=49)。DTF组口服替诺福韦酯(Tenofovir Disoprox,DTF)治疗,LdT组口服替比夫定(Telbivudine,LdT)治疗,对比两组孕妇血清乙肝病毒基因(Hepatitis B virus-DNA,HBV DNA)水平、外周血Treg/Th17平衡状态、HBV母婴传播率及不良反应。结果:治疗前后两组孕妇HBV DNA水平、HBV DNA转阴率、乙型肝炎E抗原(Hepatitis Be antigen,HBeAg)转阴率、HbeAg血清学转换率、Treg细胞、Th17细胞百分比、Treg/Th17比值、新生儿HBV感染率、不良反应发生率均无统计学意义(P>0.05)。结论:LdT与DTF两种药物对高乙型肝炎病毒载量妊娠中晚期孕妇治疗,均可有效阻断HBV母婴传播,调节免疫状态,降低HBV DNA水平,提升抗病毒效果,效果相当,安全性高,值得临床推广。展开更多
基金This study was supported by a grant from the National Natural Science Foundation of China(No.31770837)。
文摘Background and Aims:The therapeutic effect of tenofovir alafenamide fumarate(TAF),tenofovir disoproxil fumarate(TDF)and entecavir(ETV)on chronic hepatitis B(CHB)patients remains inconsistent.The aim of this study was to explore the differences in virological responses to TAF,TDF and ETV in patients with CHB.Methods:Literature searches were conducted of the PubMed,EMBASE,and the Cochrane Library databases to identify randomized controlled trials and observational studies published up to July 21,2020.Statistical comparisons of virological response between TDF,ETV,and TAF were carried out with pooled odds ratio(OR)values.Results:The virological response in TDF-treated CHB patients was notably superior to that of the ETV-treated CHB patients after 12-weeks[OR=1.12,95%confidence interval(CI):0.89–1.41],24-weeks(OR=1.33,95%CI:1.11–1.61),48-weeks(OR=1.62,95%CI:1.16–2.25),72-weeks(OR=1.43,95%CI:0.78–2.62),and 96-weeks(OR=1.56,95%CI:0.87–2.81)treatment.No significant difference was observed for the virological responses in CHB patients after 48-weeks treatment with TAF or TDF.The virological response in TDF+ETV-treated CHB patients was superior to that of TDF-treated CHB patients after 24-weeks,48-weeks(OR=1.54,95%CI:1.17–2.02),96-weeks,and 144-weeks.Conclusions:The virological response in TDF-treated CHB patients was superior to that in ETV-treated CHB patients,but there was no significant difference between TAF and TDF.In addition,the therapeutic effect of TDF+ETV was superior to TDF alone.
文摘目的:探究高乙型肝炎病毒载量妊娠中晚期孕妇使用替比夫定阻断乙型肝炎病毒(Hepatitis B virus,HBV)母婴传播的效果。方法:选取我院2018年7月至2020年10月期间收治的97例高乙型肝炎病毒载量妊娠中晚期孕妇作为研究对象,根据随机数字表法分为DTF组(n=48)和LdT组(n=49)。DTF组口服替诺福韦酯(Tenofovir Disoprox,DTF)治疗,LdT组口服替比夫定(Telbivudine,LdT)治疗,对比两组孕妇血清乙肝病毒基因(Hepatitis B virus-DNA,HBV DNA)水平、外周血Treg/Th17平衡状态、HBV母婴传播率及不良反应。结果:治疗前后两组孕妇HBV DNA水平、HBV DNA转阴率、乙型肝炎E抗原(Hepatitis Be antigen,HBeAg)转阴率、HbeAg血清学转换率、Treg细胞、Th17细胞百分比、Treg/Th17比值、新生儿HBV感染率、不良反应发生率均无统计学意义(P>0.05)。结论:LdT与DTF两种药物对高乙型肝炎病毒载量妊娠中晚期孕妇治疗,均可有效阻断HBV母婴传播,调节免疫状态,降低HBV DNA水平,提升抗病毒效果,效果相当,安全性高,值得临床推广。
