ETV与TDF联合治疗NAs经治慢性乙型肝炎低病毒血症28例48周疗效观察

Clinical observation of ETV combined with TDF in the treatment of 28 cases low-level viremia chronic hepatitis B with NAS

目的 评价ETV+TDF治疗NAs经治慢性乙型肝炎患者低病毒血症的疗效及可行性。方法 选取经核苷(酸)类似物(NAs)至少治疗48周的慢性乙型肝炎患者28例。在常规治疗基础上予以ETV0.5 mg、TDF300 mg、1次/d抗病毒治疗,监测HBV DNA定量等指标。结果 随着治疗时间的延长,患者病毒学应答率有所提高,治疗至48周时完全应答率达64.3%(18/28),总应答率达96.4%(27/28)。HBeAg定量由(4.13±1.26)COI降为(4.05±1.12)COI,但无HBeAg及HBsAg阴转。结论 ETV+TDF联合治疗NAs经治慢性乙型肝炎患者LLV的效果良好,不良反应少。

Objective To analyze and evaluate the efficacy and feasibility of ETV with TDF in the treatment of lowlevel viremia(LLV)chronic hepatitis B patients with NAS.Methods The patients with HBV DNA less than 500 IU/ml were treated with nucleoside(acid)analogues(NAs)for at least 48 weeks.The patients with high sensitive detection value between 20 IU/ml and 2000 IU/ml were selected as the research objects.On the basis of necessary conventional treatment,the patients were treated with ETV0.5 mg,qN,TDF300 mg,qd for antiviral therapy.Results With the extension of treatment time,the virological response rate of patients in this group was improved.The complete response rate was 64.3%(18/28)at 48 W,and the total response rate was 96.4%(27/28).There was no significant difference between the two groups(P>0.05).Conclusion The quantitative detection of high sensitivity HBV DNA can realize the diagnosis of LLV in patients with chronic hepatitis B.The effect of ETV combined with TDF in the treatment of NAs in patients with chronic hepatitis B is good with less adverse reactions,which is worthy of clinical application.