替诺福韦治疗不同HBV基因型HBeAg阳性慢性乙型肝炎的疗效的差异

Different Effects of Tenofovir Treatment with Different HBV Genotypes in HBe Ag Positive Chronic Hepatitis B

目的对替诺福韦治疗不同HBV基因型HBe Ag阳性慢性乙型肝炎的疗效差异进行分析与研究。方法方便选取2014年10月—2015年3月到该院接受治疗的172例不同基因型HBe Ag阳性慢性乙型肝炎患者选取为研究对象,治疗之前对患者实施HBV基因分型,记录并对比治疗前与治疗24、96周时乙肝两对半定量、肝功能和HBV-DNA定量,并对比不同HBV基因型患者的抗病毒治疗效果。结果 172例患者中HBV基因型101例为B基因型,71例HBV基因型为C基因型,未检测到其他基因型,两种HBV基因型的年龄、性别、ALT水平和HBV-DNA水平均差异无统计学意义(P>0.05)。经过治疗后,两种HBV基因型的ALT复常率、HBe Ag转阴率、HBV-DNA低于检测下限率和HBe Ag血清学转换率均差异无统计学意义(P>0.05)。但与治疗24周时相比,治疗96周后两种HBV基因型患者的ALT复常率、HBe Ag转阴率、HBV-DNA低于检测下限率以及HBe Ag血清学转换率均有所上升。结论替诺福韦对B基因型和C基因型HBe Ag阳性慢性乙型肝炎的治疗效果差异无统计学意义。

Objective This paper tries to analyze and study on the differences of efficacy of tenofovir treatment with different HBV genotypes in HBe Ag positive chronic hepatitis B. Methods 172 cases of patients with different genotypes of HBe Ag positive chronic hepatitis B from October 2014 to March 2015 treated in this hospital were convenient selected, the patients with HBV genotype before treatment were classified, two pairs of semi quantitative and liver function and HBV-DNA of hepatitis B patients before and after treatment with 24 and 96 weeks were recorded and compared, and antiviral therapy effect of different HBV genotype was compared. Results Among the 172 patients, 101 cases of HBV genotype were B genotype, 71 cases of C genotype, and no other genotypes were detected, there were no significant difference between the two genotypes of HBV in the age, gender, ALT level and HBV-DNA level（P〉0.05）. After treatment, there was no significant difference in the ALT recovery rate, HBe Ag negative rate, HBV-DNA lower than the detection limit rate and the HBe Ag seroconversion rate（P〉0.05）. However, compared with 24 weeks after treatment, the rate of ALT recovery rate, HBe Ag negative rate, HBV-DNA lower than the detection limit rate and HBe Ag seroconversion rate were increased in two HBV genotypes after 96 weeks of treatment. Conclusion There are no significant differences in the curative effects of patients with B and C genotype of HBe Ag positive chronic hepatitis B by tenofovir method.