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首页> 外文期刊>Hepatology: Official Journal of the American Association for the Study of Liver Diseases >Efficacy of tenofovir disoproxil fumarate at 240 weeks in patients with chronic hepatitis B with high baseline viral load
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Efficacy of tenofovir disoproxil fumarate at 240 weeks in patients with chronic hepatitis B with high baseline viral load

机译：替诺福韦酯富马酸替莫罗韦在240周时对基线病毒载量高的慢性乙型肝炎患者的疗效

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摘要

We evaluated the antiviral response of patients with chronic hepatitis B (CHB) who had baseline high viral load (HVL), defined as having hepatitis B virus (HBV) DNA ≥9 log10 copies/mL, after 240 weeks of tenofovir disoproxil fumarate (TDF) treatment. A total of 641 hepatitis B e antigen (HBeAg)-negative and HBeAg-positive patients (129 with HVL) received 48 weeks of TDF 300 mg (HVL n = 82) or adefovir dipivoxil (ADV) 10 mg (HVL n = 47), followed by open-label TDF for an additional 192 weeks. Patients with confirmed HBV DNA ≥400 copies/mL on or after week 72 had the option of adding emtricitabine (FTC). By week 240, 98.3% of HVL and 99.2% of non-HVL patients on treatment achieved HBV DNA 400 copies/mL. Both groups had similar rates of histologic regression between baseline and week 240. Patients with HVL generally took longer to achieve HBV DNA 400 copies/mL than non-HVL patients, but by week 96, the percentages of patients with HBV DNA 400 copies/mL were similar in both groups. Among HVL patients, time to achieving HBV DNA 400 copies/mL was shorter among those initially receiving TDF, compared to ADV. No patient with baseline HVL had persistent viremia at week 240 or amino acid substitutions associated with TDF resistance. Conclusion: CHB patients with HVL can achieve HBV DNA negativity with long-term TDF treatment, although time to HBV DNA 400 copies/mL may be longer, relative to patients with non-HVL.
机译：我们评估了240周替诺福韦酯富马酸替诺福韦（TDF）后基线高病毒载量（HVL）（定义为具有≥9 log10个拷贝/ mL的乙型肝炎病毒（HBV）DNA）的慢性乙型肝炎（CHB）患者的抗病毒反应）治疗。共有641名乙型肝炎e抗原（HBeAg）阴性和HBeAg阳性患者（129例患有HVL）接受了48周的TDF 300 mg（HVL n = 82）或阿德福韦酯（ADV）10 mg（HVL n = 47） ，然后再加上开放标签的TDF，持续192周。在第72周或之后确认HBV DNA≥400拷贝/ mL的患者可以选择加入恩曲他滨（FTC）。到第240周，接受治疗的98.3％的HVL患者和99.2％的非HVL患者达到HBV DNA <400拷贝/ mL。两组在基线和第240周之间的组织学消退率相似。HVL患者达到HBV DNA <400拷贝/ mL的时间通常比非HVL患者更长，但是到96周时，HBV DNA <400拷贝患者的百分比两组的/ mL相似。在HVL患者中，最初接受TDF的患者与ADV相比，达到HBV DNA <400拷贝/ mL的时间更短。基线HVL的患者在第240周没有持续的病毒血症或与TDF耐药相关的氨基酸替代。结论：尽管相对于非HVL患者，HBV DNA <400拷贝/ mL的时间可能更长，但长期TDF治疗可使HVL CHB患者达到HBV DNA阴性。

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