替诺福韦酯治疗慢性乙型肝炎研究进展

Recent progress of tenofovir disoproxil fumarate in the treatment of chronic hepatitis B

据2006年流行病学调查结果显示,我国1~59岁人群乙型肝炎表面抗原(HBsAg)携带率为7.18%[1-2],据此推算,我国现有的慢性乙型肝炎病毒(hepatitis B virus,HBV)感染者约9 300万例,其中慢性乙型肝炎(chronic hepatitis B,CHB)患者约3 000万例[3]。对于这部分CHB患者,及时有效地抗病毒治疗是阻断疾病进展的关键。目前抗病毒治疗药物有核苷/核苷酸类(nucleoside/nucleotide analogs,NAs)和干扰素。而我国上市的治疗CHB的NAs药物有4种,分别为拉米夫定(lamivudine,LAM)。

As a kind of nucleotide drugs, tenofovir disoproxil fumarate （TDF） has been widely used for the treatment of chronic hepatitis B （CHB） in Europe and United States with effective therapeutic results. The clinical studies have demonstrated that TDF is an effective and safe drug for both naive and treatment-experienced CHB patients. The antiviral effect of TDF is superior to adefovir. TDF represses the disease and improves the prognosis for patients with either compensated or decompensated liver diseases due to CHB. For pregnant woman with HBV infections, if necessary, TDF could be used and no evidence of drug-related birth defects have been reported. The adverse events of TDF include headache, fatigue, and etc. In addition, TDF showed few side effects on renal functions and metabolism of calcium and phosphorus; therefore, it can be used for liver transplant recipients and CHB patients with renal deficienely. So far, gene mutations associated with TDF resistance have not been found. TDF provides a new choice of antiviral therapy for CHB patients.