恩替卡韦与拉米夫定在术前HBV低复制患者肝移植术后抗病毒疗效及经济学对比

Comparison of antiviral efficacy and economics between lamivudine and entecavir in patients with low preoperative HBV replication after liver transplantation

目的:对比恩替卡韦与拉米夫定在预防术前HBV低复制患者肝移植术后乙肝复发的疗效及经济学对比,探讨肝移植术后预防HBV再感染的治疗策略。方法:选取自2006年7月至2013年7月于我院行肝移植的患者进行前瞻性研究,通过分析术后随访血清学转阴及HBV再感染情况进行统计分析。结果:恩替卡韦组51例,术后1个月累积转阴率98.04%,发现3例出现再感染,再感染率5.88%,平均转阴时间9.73 d。拉米夫定组26例,术后1个月累积转阴率100%,有3例出现了HBV再感染,再感染率为11.54%,平均转阴时间为5.11 d。恩替卡韦组与拉米夫定组的平均转阴时间、累积转阴率、再感染率,累积再感染率均无统计学差异。结论:在HBV低复制的情况下,恩替卡韦、拉米夫定对术后HBV再感染的疗效相当,拉米夫定更经济。

Objective To compare the antiviral efficacy and economics between lamivudine and entecavir in patients with low preoperative HBV replication after liver transplantation. Methods Liver transplantation patients from 2006 July to 2013 July were selected for being studied prospectively. Statistically evaluated between entecavir and lamivudine efficacy by the analysis of postoperative follow-up of seroconversion and HBV reinfection. Results The cumulative overcast rate of entecavir group was 98.04% one month after transplatation. And 3 of 51 cases were reinfected with average turn time of 9.73 days. Meanwhile , the cumulative overcast rate of Lamivudine group was 100% and 3 of 26 cases were reinfected with average turn time of 5.11 days. There are no statistical differences between the two groups accumulation rate , reinfection rates , as well as cumulative infection rates. Conclusion In the cases of low hepatitis B virus replication before liver transplantation, Entecavir and Lamivudine have the similar effect of preventing HBV reinfection after operation. Compared with the cost of Entecavir group, Lamivudine is more economy.