ETV与TDF联合治疗NAs经治慢性乙型肝炎低病毒血症28例48周疗效观察

肝脏 ›› 2022, Vol. 27 ›› Issue (2): 222-224.

ETV与TDF联合治疗NAs经治慢性乙型肝炎低病毒血症28例48周疗效观察

宋庆润, 高峰, 杨小平, 刘俊青, 向龙春, 韩丽英

735000 甘肃酒泉市人民医院感染科(宋庆润,高峰,杨小平),检验科(刘俊青);酒泉市第二人民医院感染科(向龙春);酒钢职工医院感染科(韩丽英)

收稿日期:2021-04-08 出版日期:2022-02-28 发布日期:2022-04-19
通讯作者: 杨小平,Email:xpyzry@163.com

Clinical observation of ETV combined with TDF in the treatment of 28 cases low-level viremia chronic hepatitis B with NAS

SONG Qing-run¹, GAO Feng¹, YANG Xiao-ping¹, LIU Jun-qing², XIANG Long-chun³, HAN Li-ying⁴

1. Department of Infection,
2. Department of Laboratory,Jiuquan People's Hospital, Gansu 735000, China;
3.Department of Infectious disease, Jiuquan Second People's Hospital,Gansu 735000, China;
4. Department of Infection,Staff Hospital of Jiuquan Iron and Steel Group Company, Gansu 735000, China

Received:2021-04-08 Online:2022-02-28 Published:2022-04-19
Contact: YANG Xiao-ping, Email:xpyzry@163.com

摘要/Abstract

摘要： 目的评价ETV+TDF治疗NAs经治慢性乙型肝炎患者低病毒血症的疗效及可行性。方法选取经核苷(酸)类似物(NAs)至少治疗48周的慢性乙型肝炎患者28例。在常规治疗基础上予以ETV 0.5 mg、TDF 300 mg、1次/d抗病毒治疗,监测HBV DNA定量等指标。结果随着治疗时间的延长,患者病毒学应答率有所提高,治疗至48周时完全应答率达64.3%(18/28),总应答率达96.4%(27/28)。HBeAg定量由(4.13±1.26)COI降为(4.05±1.12)COI,但无HBeAg及HBsAg阴转。结论 ETV+TDF联合治疗NAs经治慢性乙型肝炎患者LLV的效果良好,不良反应少。

关键词: 病毒性肝炎,乙型,慢性, 低病毒血症, 恩替苄韦, 富马酸替诺福韦

Abstract: Objective To analyze and evaluate the efficacy and feasibility of ETV with TDF in the treatment of low-level viremia (LLV) chronic hepatitis B patients with NAS. Methods The patients with HBV DNA less than 500 IU/ml were treated with nucleoside (acid) analogues (NAs) for at least 48 weeks. The patients with high sensitive detection value between 20 IU/ml and 2000 IU/ml were selected as the research objects. On the basis of necessary conventional treatment, the patients were treated with ETV 0.5 mg, qN, TDF 300 mg, qd for antiviral therapy. Results With the extension of treatment time, the virological response rate of patients in this group was improved. The complete response rate was 64.3% (18/28) at 48W, and the total response rate was 96.4% (27/28). There was no significant difference between the two groups (P>0.05). Conclusion The quantitative detection of high sensitivity HBV DNA can realize the diagnosis of LLV in patients with chronic hepatitis B. The effect of ETV combined with TDF in the treatment of NAs in patients with chronic hepatitis B is good with less adverse reactions, which is worthy of clinical application.

Key words: Chronic hepatitis B, Low-level viremia, Treatment

宋庆润, 高峰, 杨小平, 刘俊青, 向龙春, 韩丽英. ETV与TDF联合治疗NAs经治慢性乙型肝炎低病毒血症28例48周疗效观察[J]. 肝脏, 2022, 27(2): 222-224.

SONG Qing-run, GAO Feng, YANG Xiao-ping, LIU Jun-qing, XIANG Long-chun, HAN Li-ying. Clinical observation of ETV combined with TDF in the treatment of 28 cases low-level viremia chronic hepatitis B with NAS[J]. Chinese Hepatolgy, 2022, 27(2): 222-224.