Clinical effect of entecavir in treatment of patients with chronic hepatitis B complicated by tuberculosis

Objective To investigate the clinical effect of entecavir in the treatment of patients with chronic hepatitis B( CHB) complicated by tuberculosis during anti- tuberculosis treatment. Methods A retrospective study was performed for the clinical data of 95 patients with CHB complicated by tuberculosis,and according to the application of entecavir antiviral therapy during anti- tuberculosis treatment,these patients were divided into treatment group and control group. The changes in clinical biochemical parameters and prognosis after treatment were compared between the two groups. The t- test or Mann- Whitney U test were used for comparison of continuous data between groups,and the chi- square test was used for comparison of categorical data between groups. Results During the treatment,compared with the treatment group,the control group had significantly higher alanine aminotransferase [382. 7( 260. 7- 635. 9) U / L vs 143. 3( 97. 9-260. 4) U / L,Z =- 4. 225,P < 0. 001] and aspartate aminotransferase [280. 7( 197. 6- 461. 8) U / L vs 93. 8( 67. 3- 156. 9) U / L,Z =- 4. 637,P < 0. 001]and significant increases in total bilirubin [157. 4( 139. 7- 269. 6) μmol / L vs 106. 8( 88. 3- 187. 1) μmol / L,Z =- 2. 671,P = 0. 008] and the proportion of patients with jaundice( 63. 2% vs 34. 2%,χ2= 7. 650,P = 0. 007). Compared with the treatment group,the control group had a significantly prolonged prothrombin time( 22. 5 ± 15. 5 s vs 17. 3 ± 9. 7 s,t = 2. 553,P = 0. 012)and a significantly lower platelet count [( 131. 0 ± 69. 4) × 109/ L vs( 181. 7 ± 105. 6) × 109/ L,t = 2. 826,P = 0. 004] during treatment.Compared with the treatment group,the control group had significant increases in the proportions of patients with liver failure( 42. 1% vs15. 8%,χ2= 7. 306,P < 0. 001) and patients who were forced to stop all or part of antitubercular agents due to liver impairment during treatment( withdrawal of all antitubercular agents: 17. 5% vs 2. 6%,χ2= 4. 952,P = 0. 026; withdrawal of part of antitubercular agents: 68. 4%vs 15. 8%,χ2= 25. 330,P < 0. 001). Conclusion During the anti- tuberculosis treatment for patients with CHB complicated by tuberculosis,entecavir antiviral therapy can effectively reduce the incidence of liver injury during anti- tuberculosis treatment and ensure the effect and safety of anti- tuberculosis treatment; therefore,it holds promise for further clinical research.