Clinical effect of tenofovir disoproxil fumarate versus entecavir in treatment of treatment-naïve patients with chronic HBV infection

Zhang JiaWei; Geng JiaBao; Lu Feng; Dong Yu

doi:10.3969/j.issn.1001-5256.2018.02.011

Issue 2

Feb. 2018

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > Journal of Clinical Hepatology > 2018 > 34(2): 272-275

PDF( 1559 KB)

Clinical effect of tenofovir disoproxil fumarate versus entecavir in treatment of treatment-naïve patients with chronic HBV infection

DOI: 10.3969/j.issn.1001-5256.2018.02.011

Department of Infectious Diseases, Zhoukou Central Hospital

Published Date: 2018-02-20

Abstract

Abstract

Objective To investigate the antiviral effect of tenofovir disoproxil fumarate (TDF) versus entecavir (ETV) in the treatment of treatment-nave patients with chronic HBV infection.Methods A total of 420 treatment-nave patients with chronic HBV infection or liver cirrhosis who received antiviral therapy with TDF or ETV and were regularly followed up in Zhoukou Central Hospital or Bayi Hospital Affiliated to Nanjing University of Chinese Medicine from July 2014 to July 2015 were enrolled, and among these patients, 184 received TDF (TDF group) and 236 received ETV (ETV group) .Laboratory markers were measured at baseline and at weeks 4, 8, 12, 24, and 48 of treatment, including liver and renal function parameters, blood calcium, serum phosphate, creatine kinase, HBV DNA level, hepatitis markers (HBs Ag, HBeAg, and anti-HBe) .Adverse drug reactions were also monitored.The t-test was used for comparison of continuous data between groups, and the chi-square test or Fisher's exact test was used for comparison of categorical data between groups.Results At week 48 of treatment, there were no significant differences between the two groups in HBeAg clearance rate among both HBeAg-positive patients and HBeAg-positive patients with HBV DNA > 6 lg IU/ml (P > 0.05) .There were also no significant differences between the two groups in alanine aminotransferase normalization rate among HBeAg-negative patients, HBeAg-positive patients, and HBeAg-positive patients with HBV DNA > 6 lg IU/ml (P > 0.05) .Both groups had a gradual reduction in HBV DNA level after the antiviral therapy.At week 48 of treatment, there were significant differences between the TDF group and the ETV group in the proportion of patients with a HBV DNA level below the lower limit of detection among HBeAg-positive patients (75.5% vs 60.8%, χ2= 5.857, P = 0.016) and HBeAg-positive patients with HBV DNA > 6 lg IU/ml (75.7% vs 60.5%, χ2= 5.722, P = 0.017) .At week 96 of treatment, the TDF group had a significantly higher rate of HBV DNA below the lower limit of detection than the ETV group among all patients (93.5% vs 86.9%, χ2=4.921, P = 0.027) , HBeAg-positive patients (89.1% vs 76.2%, χ2= 6.781, P = 0.009) , and HBeAg-positive patients with HBV DNA > 6 lg IU/ml (88.3% vs 73.7%, χ2= 7.456, P = 0.006) .Conclusion In HBeAg-positive patients with chronic HBV infection, TDF has a better inhibitory effect on HBV DNA than ETV, especially in those with HBV DNA > 6 lg IU/ml.
- hepatitis B, chronic,
- tenofovir disoproxil fumarate,
- entecavir,
- treatment outcome

FullText(HTML)

References(19)

References

[1]SARIN SK, KUMAR M, LAU GK, et al.Asian-Pacific clinical practice guidelines on the management of hepatitis B:a 2015 update[J].Hepatol Int, 2016, 10 (1) :1-98.

[2]YAN YP, SU HX, JI ZH, et al.Epidemiology of hepatitis B virus infection in China:current status and challenges[J].J Clin Transl Hepatol, 2014, 2 (1) :15-22.

[3]LOK AS, MCMAHON BJ.Chronic hepatitis B:update 2009[J].Hepatology, 2009, 50 (3) :661-662.

[4]SCHUTTE K, BALBISI F, MALFERTHEINER P.Prevention of hepatocellular carcinoma[J].Gastrointest Tumors, 2016, 3 (1) :37-43.

[5]XU W, YU J, WONG VW.Mechanism and prediction of HCC development in HBV infection[J].Best Pract Res Clin Gastroenterol, 2017, 31 (3) :291-298.

[6]WANG FM, LIU JT.Clinical efficacy of entecavir combined with Ganfule capsules in treatment of 80 cases of chronic hepatitis B with hepatic fibrosis[J/CD].Chin J Liver Dis:Electronic Edition, 2016, 8 (2) :95-98. (in Chinese) 王芳梅, 刘金涛.恩替卡韦联合肝复乐胶囊治疗慢性乙型肝炎肝纤维化80例疗效观察[J/CD].中国肝脏病杂志:电子版, 2016, 8 (2) :95-98.

[7]ZHANG Y, YU YS, TANG ZH, et al.Clinical study of entecavir combined with kushenin improving the Th1/Th2 imbalance in patients with HBeAg-positive chronic hepatitis B[J].Chin J Clin Pharmacol Ther, 2016, 21 (10) :1168-1172. (in Chinese) 张毅, 余永胜, 汤正好, 等.恩替卡韦联合苦参素改善HBeAg阳性慢性乙型肝炎患者Th1/Th2失平衡临床研究[J].中国临床药理学与治疗学, 2016, 21 (10) :1168-1172.

[8]Chinese Society of Hepatology and Chinese Society of Infectious Diseases Chinese, Medical Association.The guideline of prevention and treatment for Chronic hepatitis B:a 2015 update[J].J Clin Hepatol, 2015, 31 (12) :1941-1960. (in Chinese) 中华医学会肝病学分会, 中华医学会感染病学分会.慢性乙型肝炎防治指南 (2015年更新版) [J].临床肝胆病杂志, 2015, 31 (12) :1941-1960.

[9]FAN R, SUN J, HOU JL.Antiviral therapy for chronic hepatitis B:current status and perspectives[J].J Clin Hepatol, 2016, 32 (11) :2029-2032. (in Chinese) 樊蓉, 孙剑, 侯金林.慢性乙型肝炎抗病毒治疗现状及展望[J].临床肝胆病杂志, 2016, 32 (11) :2029-2032.

[10]HA NB, TRINH HN, ROSENBLATT L, et al.Treatment outcomes with first-line therapies with entecavir and tenofovir in treatmentnaive chronic hepatitis B patients in a routine clinical practice[J].J Clin Gastroenterol, 2016, 50 (2) :169-174.

[11]IDILMAN R, GUNSAR F, KORUK M, et al.Long-term entecavir or tenofovir disoproxil fumarate therapy in treatment-na6ve chronic hepatitis B patients in the real-world setting[J].J Viral Hepat, 2015, 22 (5) :504-510.

[12]BATIREL A, GUCLU E, ARSLAN F, et al.Comparable efficacy of tenofovir versus entecavir and predictors of response in treatment-na6ve patients with chronic hepatitis B:a multicenter real-life study[J].Int J Infect Dis, 2014, 28 (11) :153-159.

[13]OZARAS R, METE B, CEYLAN B, et al.First-line monotherapies of tenofovir and entecavir have comparable efficacies in hepatitis B treatment[J].Eur J Gastroenterol Hepatol, 2014, 26 (7) :774-780.

[14]GAO L, TRINH HN, LI J, et al.Tenofovir is superior to entecavir for achieving complete viral suppression in HBeAg-positive chronic hepatitis B patients with high HBV DNA[J].Aliment Pharmacol Ther, 2014, 39 (6) :629-637.

[15]YOO EH, CHO HJ.Clinical response to long-term tenofovir monotherapy in Korean chronic hepatitis B patients[J].Clin Chim Acta, 2017, 471 (8) :308-313.

[16]MURAT K, FATMA S, YESIM A, et al.Head-to-head comparison of two years efficacy of entecavir and tenofovir in patients with treatment-na6ve chronic hepatitis B--The real life data[J].Hepatogastroenterology, 2015, 62 (140) :982-986.

[17]CHANG TT, GISH RG, de MAN R, et al.A comparison of entecavir and lamivudine for HBeAg-positive chronic hepatitis B[J].N Engl J Med, 2006, 354 (10) :1001-1010.

[18]MARCELLIN P, HEATHCOTE EJ, BUTI M, et al.Tenofovir disoproxil fumarate versus adefovir dipivoxil for chronic hepatitis B[J].N Engl J Med, 2008, 359 (23) :2442-2455.

[19]LOPEZ CENTENO B, COLLADO BORRELL R, PEREZ ENCINAS M, et al.Comparison of the effectiveness and renal safety of tenofovir versus entecavir in patients with chronic hepatitis B[J].Farm Hosp, 2016, 40 (4) :279-286.

Relative Articles

[1]	Ruitao YANG, Rui YANG, Xun DENG, Senxiang ZENG, Xiaoyan YANG. Diagnosis and treatment principles of liver injury induced by antithyroid drugs[J]. Journal of Clinical Hepatology, 2024, 40(3): 621-625. doi: 10.12449/JCH240331
[2]	Guojing XING, Longlong LUO, Lifei WANG, Shunna WANG, Xiaofeng ZHENG, Lixia LU, Jiucong ZHANG. Role of mesenchymal stem cells and their exosomes in the treatment of drug-induced liver injury[J]. Journal of Clinical Hepatology, 2024, 40(3): 633-638. doi: 10.12449/JCH240333
[3]	Rui CHEN, Zhixin WANG, Haining FAN, Haijiu WANG. Research advances in the role of lymphocyte activation gene-3 in liver-related diseases[J]. Journal of Clinical Hepatology, 2021, 37(4): 977-981. doi: 10.3969/j.issn.1001-5256.2021.04.056
[4]	Hou JunXing, Yan FenQin, Yu YueCheng. The pathogenesis,diagnosis,and treatment of drug-induced liver injury with extrahepatic adverse drug reactions[J]. Journal of Clinical Hepatology, 2020, 36(3): 497-500. doi: 10.3969/j.issn.1001-5256.2020.03.003
[5]	Jing Jing, He TingTing, Wang RuiLin, Zhang Fan, Niu Ming, Guo YuMing, Zhu Yun, Xiao XiaoHe, Wang JiaBo. Detection of the risk signals of drug-induced liver injury: Challenges and advances[J]. Journal of Clinical Hepatology, 2020, 36(3): 491-496. doi: 10.3969/j.issn.1001-5256.2020.03.002
[6]	Huang Ang, Sun Ying, Zou ZhengSheng. Recent research advances in chronicity of drug-induced liver injury[J]. Journal of Clinical Hepatology, 2020, 36(3): 501-504. doi: 10.3969/j.issn.1001-5256.2020.03.004
[7]	Xiao XiaoHe. Combination of medicine and pharmacy assists for precise prevention and control of drug-induced liver injury[J]. Journal of Clinical Hepatology, 2020, 36(3): 489-490. doi: 10.3969/j.issn.1001-5256.2020.03.001
[8]	Yang Xue, Tu RongFang, Yang JinHui. Research advances in drug-induced liver injury[J]. Journal of Clinical Hepatology, 2020, 36(3): 509-513. doi: 10.3969/j.issn.1001-5256.2020.03.006
[9]	Ye LiHong, Wang ChongKui, Shao Chen, Zhang HaiCong, Liu ZhiQuan, Wang TaiLing. Clinical and biochemical features of bile duct injury type of drug-induced liver injury[J]. Journal of Clinical Hepatology, 2020, 36(5): 1059-1064. doi: 10.3969/j.issn.1001-5256.2020.05.022
[10]	Liu Meng, Yang XuanZi, Yu LeCheng. Current status of the pathogenesis, diagnosis, and treatment of drug-induced cholestasis[J]. Journal of Clinical Hepatology, 2019, 35(2): 252-257. doi: 10.3969/j.issn.1001-5256.2019.02.003
[11]	Han Ying, Chen Jie, Dan Jing, Liu YanMin, Zhang XiaoDan, Ren MeiXin, Du XiaoFei, Bian XinQu, Liu Dan, Huang YunLi, Huang ChunYang, Liao HuiYu. Value of fumarate hydratase antibody in differential diagnosis of autoimmune hepatitis and drug-induced liver injury[J]. Journal of Clinical Hepatology, 2019, 35(6): 1326-1329. doi: 10.3969/j.issn.1001-5256.2019.06.029
[12]	Kong XiaoLu, Shao Xue, Li DongFu. Senile intestinal lymphangiectasia with drug-induced liver injury: A case report[J]. Journal of Clinical Hepatology, 2019, 35(8): 1800-1802. doi: 10.3969/j.issn.1001-5256.2019.08.030
[13]	Bian ZhaoLian, Shao JianGuo, Ma Xiong. Differential diagnosis of drug-induced liver injury and autoimmune hepatitis and related therapeutic strategies[J]. Journal of Clinical Hepatology, 2018, 34(6): 1156-1159. doi: 10.3969/j.issn.1001-5256.2018.06.003
[14]	Yu LeCheng, Fan Ye, Chen ChengWei. Diagnosis and treatment of drug-induced liver injury[J]. Journal of Clinical Hepatology, 2018, 34(6): 1160-1165. doi: 10.3969/j.issn.1001-5256.2018.06.004
[15]	Chou LiXia, Fan ZuoPeng, Liu Ying, Liang Shan, Nie Wei, Lin Wei, Liu YiRong, Zhang Jing, Hu ZhongJie. Application of a modified diagnostic scale in diagnosis of acute drug-induced liver injury[J]. Journal of Clinical Hepatology, 2017, 33(7): 1328-1331. doi: 10.3969/j.issn.1001-5256.2017.07.025
[16]	Ji ChenHua, Zhang ZhuQing, Wang XiaoYuan, Lu ShuMing. Clinical features of elderly patients with drug-induced liver injury[J]. Journal of Clinical Hepatology, 2017, 33(3): 502-506. doi: 10.3969/j.issn.1001-5256.2017.03.021
[17]	Zhang Dong, Zhang Tao, Wu YuNan, Sun KeWei. A systematic analysis of the application of diagnostic criteria for drug-induced liver injury in China based on the literature[J]. Journal of Clinical Hepatology, 2017, 33(5): 919-923. doi: 10.3969/j.issn.1001-5256.2017.05.026
[18]	Yuan Ling, Yang YongGeng, Shen YouXiu, Ma YingCai. Research advances in drug- induced liver injury[J]. Journal of Clinical Hepatology, 2017, 33(2): 375-378. doi: 10.3969/j.issn.1001-5256.2017.02.038
[19]	Yu YueCheng, Fan Ye. Advances in Roussel Uclaf Causality Assessment Method for diagnosis of drug-induced liver injury and its comparison with structured expert opinion process[J]. Journal of Clinical Hepatology, 2016, 32(9): 1706-1713. doi: 10.3969/j.issn.1001-5256.2016.09.014
[20]	Lu Yi, Yu Hui. Discussion on idiosyncratic drug-induced liver injury in children[J]. Journal of Clinical Hepatology, 2015, 31(8): 1215-1217. doi: 10.3969/j.issn.1001-5256.2015.08.008

Supplements(0)

Cited By

Proportional views

Proportional views

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

Get Citation

PDF

XML

Article Metrics

Article views (3482) PDF downloads(545)

Clinical effect of tenofovir disoproxil fumarate versus entecavir in treatment of treatment-naïve patients with chronic HBV infection

DOI: 10.3969/j.issn.1001-5256.2018.02.011

Abstract

References

Relative Articles

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Clinical effect of tenofovir disoproxil fumarate versus entecavir in treatment of treatment-naïve patients with chronic HBV infection

DOI: 10.3969/j.issn.1001-5256.2018.02.011

Abstract

References

Relative Articles

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content