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富马酸丙酚替诺福韦治疗特殊慢性乙型肝炎的相关进展

宋玉文 沙丽丽 陈立震 李梦昆 王玉荣 辛永宁

引用本文:
Citation:

富马酸丙酚替诺福韦治疗特殊慢性乙型肝炎的相关进展

DOI: 10.3969/j.issn.1001-5256.2023.01.024
基金项目: 

慢性乙肝临床研究项目 (IN-CN-320-5837)

利益冲突声明:所有作者均声明不存在利益冲突。
作者贡献声明:宋玉文负责查阅文献,撰写文章;沙丽丽、李梦昆、王玉荣参与论文起草;陈立震参与起草、修改文章关键内容;辛永宁参与指导,修改撰写文章并最后定稿。
详细信息
    通信作者:

    辛永宁,xinyongning@163.com (ORCID: 0000-0002-3692-7655)

Research advances in tenofovir alafenamide fumarate in treatment of special chronic hepatitis B

Research funding: 

Chronic Hepatitis B Clinical Research Project (IN-CN-320-5837)

More Information
  • 摘要: 我国HBV感染人数众多,严重危害公共卫生安全。富马酸丙酚替诺福韦(TAF)作为临床一线用药,具有强效、低耐药、骨肾安全等特点。本文归纳总结了TAF在低病毒血症、多重耐药、妊娠期、肝衰竭及肝移植等特殊类型慢性乙型肝炎患者中的作用,分析表明TAF能够降低低病毒血症患者病毒载量实现病毒学应答、为耐药患者提供新方案、阻断母婴传播、降低终末期肝病患者病死率、改善慢性肾脏病患者肾功能。

     

  • 表  1  TAF在LLV患者中的疗效

    Table  1.   Efficacy of TAF in patients with LLV

    学者 治疗方案 治疗周期 基线期LLV例数 治疗后HBV DNA<20 IU/mL HBeAg转阴 ALT复常率(≤40 U/L)
    Ogawa E[10] ETV换TAF 48周 34 97.1%(33/34) - -
    NUC换TAF 9 77.8%(7/9) - -
    Ogawa E[11] ETV换TAF 96周 34 97.1%(33/34) - -
    TDF换TAF 7 71.4%(5/7) - -
    NUC换TAF 10 80%(8/10) - -
    Li ZB[12] ETV换TAF 12周 75 54.7% (41/75) 3.9% (2/51) 42.9%(9/21)
    继续ETV 75 6.7% (5/75) 1.9%(1/52) 10.5%(2/19)
    ETV换TAF 24周 75 62.7% (47/75) 7.8%(4/51) 47.6%(10/21)
    继续ETV 75 9.3% (7/75) 3.8%(2/52) 10.5%(2/19)
    Yan D[13] ETV换TAF 12周 104 41.8%1) - 91.8%
    继续ETV 395 8%1) - 82.8%
    ETV换TAF 24周 104 79.4%1) - 92.6%
    继续ETV 395 9.1%1) - 80.6%
    注:1)治疗后HBV DNA<30 IU/mL患者占比。
    下载: 导出CSV

    表  2  妊娠期CHB患者抗病毒治疗效果汇总

    Table  2.   Efficacy of antiviral therapy in pregnant CHB patients

    学者 治疗方案 患者例数 开始应用药物的孕周(周) 基线期HBV DNA(log10 IU/mL) 分娩时HBV DNA(log10 IU/mL) 婴儿人数 母婴传播率(%)
    Zeng QL[17] TAF组 116 28 7.8±0.7 3.5±0.9 117 0
    TDF组 116 28 7.8±0.7 3.4±1.0 116 0
    Li B[18] TAF组 36 24 7.95±0.40 3.51±0.61 36 0
    TDF组 36 24 7.85±0.41 3.45±0.59 36 0
    Ding Y[19] TAF组 71 27 7.78±0.72 4.09±1.12 73 0
    Chen R[20] TAF组 98 47例孕早期、51例孕中期 7.07±0.91 4.09±1.12 98 0
    Zeng QL[21] TAF组 103 1.3(±14.6) 5.1±3.4 1.2±1.7 102 0
    TDF组 104 1.0(±12.3) 4.6±3.4 0.9±1.4 103 0
    Zhu YX[22] TAF组 51 24~28 8.07±8.10 3.43±1.30(下降水平) - 0
    TDF组 51 24~28 8.06±8.13 3.70±0.91(下降水平) - 0
    下载: 导出CSV
  • [1] WHO. Hepatitis B[EB/OL]. (2022-6-24)[2022-07-15]. https://www.who.int/news-room/fact-sheets/detail/hepatitis-b.
    [2] WANG H, MEN P, XIAO Y, et al. Hepatitis B infection in the general population of China: a systematic review and meta-analysis[J]. BMC Infect Dis, 2019, 19(1): 811. DOI: 10.1186/s12879-019-4428-y.
    [3] JIN Q. A meta-analysis of studies on the incidence and prevalence of hepatitis B in mainland China from 2008 to 2018[D]. Tianjin: Tianjin Medical University, 2020.

    金奇. 2008-2018年中国大陆乙肝发病率与患病率研究的荟萃分析[D]. 天津: 天津医科大学, 2020.
    [4] MENG TT, MIAO N, WANG FZ, et al. Analysis on hepatitis B cases reported from surveillance points in China, 2019[J]. Chin J Epidemiol, 2021, 42(9): 1532-1536. DOI: 10.3760/cma.j.cn112338-20210319-00233.

    孟彤彤, 缪宁, 王富珍, 等. 中国2019年乙型肝炎监测试点报告病例分析[J]. 中华流行病学杂志, 2021, 42(9): 1532- 1536. DOI: 10.3760/cma.j.cn112338-20210319-00233.
    [5] Chinese Society of Infectious Diseases, Chinese Medical Association, Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B (version 2019)[J]. J Clin Hepatol, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.

    中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.
    [6] LU FM, FENG B, ZHENG SJ, et al. Current status of the research on low-level viremia in chronic hepatitis B patients receiving nucleos(t)ide analogues[J]. J Clin Hepatol, 2021, 37(6): 1268-1274. DOI: 10.3969/j.issn.1001-5256.2021.06.007.

    鲁凤民, 封波, 郑素军, 等. 核苷(酸)类似物经治的慢性乙型肝炎患者低病毒血症的研究现状[J]. 临床肝胆病杂志, 2021, 37(6): 1268-1274. DOI: 10.3969/j.issn.1001-5256.2021.06.007.
    [7] SUN Y, WU X, ZHOU J, et al. Persistent low level of hepatitis B virus promotes fibrosis progression during therapy[J]. Clin Gastroenterol Hepatol, 2020, 18(11): 2582-2591. e6. DOI: 10.1016/j.cgh.2020.03.001.
    [8] KIM JH, SINN DH, KANG W, et al. Low-level viremia and the increased risk of hepatocellular carcinoma in patients receiving entecavir treatment[J]. Hepatology, 2017, 66(2): 335-343. DOI: 10.1002/hep.28916.
    [9] ZHANG Q, PENG H, LIU X, et al. Chronic hepatitis B infection with low level viremia correlates with the progression of the liver disease[J]. J Clin Transl Hepatol, 2021, 9(6): 850-859. DOI: 10.14218/JCTH.2021.00046.
    [10] OGAWA E, NOMURA H, NAKAMUTA M, et al. Tenofovir alafenamide after switching from entecavir or nucleos(t)ide combination therapy for patients with chronic hepatitis B[J]. Liver Int, 2020, 40(7): 1578-1589. DOI: 10.1111/liv.14482.
    [11] OGAWA E, NAKAMUTA M, KOYANAGI T, et al. Sequential HBV treatment with tenofovir alafenamide for patients with chronic hepatitis B: week 96 results from a real-world, multicenter cohort study[J]. Hepatol Int, 2022, 16(2): 282-293. DOI: 10.1007/s12072-021-10295-3.
    [12] LI ZB, LI L, NIU XX, et al. Switching from entecavir to tenofovir alafenamide for chronic hepatitis B patients with low-level viraemia[J]. Liver Int, 2021, 41(6): 1254-1264. DOI: 10.1111/liv.14786.
    [13] YANG D, YANG RW. Significance of switching from ETV to TAF for CHB patients with suboptimal response to ETV: A Retrospective Cohort Study[R]. APASL, 2021.
    [14] BYUN KS, CHOI J, KIM JH, et al. Tenofovir alafenamide for drug-resistant hepatitis B: A randomized trial for switching from tenofovir disoproxil fumarate[J]. Clin Gastroenterol Hepatol, 2022, 20(2): 427-437. e5. DOI: 10.1016/j.cgh.2021.04.045.
    [15] GROSSI G, LOGLIO A, FACCHETTI F, et al. Tenofovir alafenamide as a rescue therapy in a patient with HBV-cirrhosis with a history of Fanconi syndrome and multidrug resistance[J]. J Hepatol, 2017. DOI: 10.1016/j.jhep.2017.08.020.[Online ahead of print]
    [16] World Health Oraganization. Prevention of mother-to-child transmission of hepatitis B virus: guidelines on antiviral prophylaxis in pregnancy[R]. Geneva: World Health Oraganization, 2020.
    [17] ZENG QL, YU ZJ, JI F, et al. Tenofovir alafenamide to prevent perinatal hepatitis B transmission: a multicenter, prospective, observational study[J]. Clin Infect Dis, 2021, 73(9): e3324-e3332. DOI: 10.1093/cid/ciaa1939.
    [18] LI B, LIU Z, LIU X, et al. Efficacy and safety of tenofovir disoproxil fumarate and tenofovir alafenamide fumarate in preventing HBV vertical transmission of high maternal viral load[J]. Hepatol Int, 2021, 15(5): 1103-1108. DOI: 10.1007/s12072-021-10235-1.
    [19] DING Y, CAO L, ZHU L, et al. Efficacy and safety of tenofovir alafenamide fumarate for preventing mother-to-child transmission of hepatitis B virus: a national cohort study[J]. Aliment Pharmacol Ther, 2020, 52(8): 1377-1386. DOI: 10.1111/apt.16043.
    [20] CHEN R, ZOU J, LONG L, et al. Safety and efficacy of tenofovir alafenamide fumarate in early-middle pregnancy for mothers with chronic hepatitis B[J]. Front Med (Lausanne), 2021, 8: 796901. DOI: 10.3389/fmed.2021.796901.
    [21] ZENG QL, ZHANG HX, ZHANG JY, et al. Tenofovir alafenamide for pregnant Chinese women with active chronic hepatitis B: a multicenter prospective study[J]. Clin Gastroenterol Hepatol, 2021. DOI: 10.1016/j.cgh.2021.12.012.
    [22] ZHU Y, WANG J, WANG M, et al. The comparison of tenofovir alafenamide fumarate with tenofovir disoproxil fumarate in preventing hepatitis B transmission in mothers with high viral load a retrospective cohort study[R]. EASL, 2022.
    [23] Obstetrics Subgroup, Chinese Society of Obstetrics and Gynecology, Chinese Medical Association, Chinese Society of Perinatal Medicine, Chinese Medical Association. 2020 clinical guidelines on prevention of mother-to-child transmission of hepatitis B virus[J]. J Clin Hepatol, 2020, 36(7): 1474-1481. DOI: 10.3760/cma.j.cn112141-20200213-00101.

    中华医学会妇产科学分会产科学组, 中华医学会围产医学分会. 乙型肝炎病毒母婴传播预防临床指南(2020)[J]. 临床肝胆病杂志, 2020, 36(7): 1474-1481. DOI: 10.3760/cma.j.cn112141-20200213-00101.
    [24] PENG WT, GU HM, JIANG C, et al. Comparison of tenofovir alafenamide and entecavir for hepatitis B virus-related acute-on-chronic liver failure[J]. J Cent South Univ(Med Sci), 2022, 47(2): 194-201. DOI: 10.11817/j.issn.1672-7347.2022.210578.

    彭文婷, 顾慧敏, 蒋川, 等. 富马酸丙酚替诺福韦与恩替卡韦治疗乙型肝炎病毒相关慢加急性肝衰竭的效果对比[J]. 中南大学学报(医学版), 2022, 47(2): 194-201. DOI: 10.11817/j.issn.1672-7347.2022.210578.
    [25] ZHANG Y, XU W, ZHU X, et al. The 48-week safety and therapeutic effects of tenofovir alafenamide in hbv-related acute-on-chronic liver failure: A prospective cohort study[J]. J Viral Hepat, 2021, 28(4): 592-600. DOI: 10.1111/jvh.13468.
    [26] JIANG QQ, HAN MF, MA K, et al. Acute kidney injury in acute-on-chronic liver failure is different from in decompensated cirrhosis[J]. World J Gastroenterol, 2018, 24(21): 2300-2310. DOI: 10.3748/wjg.v24.i21.2300.
    [27] ORFANIDOU A, PAPATHEODORIDIS GV, CHOLONGITAS E. Antiviral prophylaxis against hepatitis B recurrence after liver transplantation: Current concepts[J]. Liver Int, 2021, 41(7): 1448-1461. DOI: 10.1111/liv.14860.
    [28] CHOLONGITAS E, PAPATHEODORIDIS GV. High genetic barrier nucleos(t)ide analogue(s) for prophylaxis from hepatitis B virus recurrence after liver transplantation: a systematic review[J]. Am J Transplant, 2013, 13(2): 353-362. DOI: 10.1111/j.1600-6143.2012.04315.x.
    [29] SAAB S, SONG D, CHALLITA YP, et al. Long-term outcomes with oral therapy in liver transplant recipients with hepatitis B[J]. Clin Transplant, 2019, 33(12): e13740. DOI: 10.1111/ctr.13740.
    [30] RASHIDI-ALAVIJEH J, STRAUB K, ACHTERFELD A, et al. Safety and efficacy of tenofovir alafenamide in liver transplant recipients: A single center experience[J]. Transpl Infect Dis, 2021, 23(3): e13522. DOI: 10.1111/tid.13522.
    [31] SRIPONGPUN P, MANNALITHARA A, KWO PY, et al. Potential benefits of switching liver transplant recipients to tenofovir alafenamide prophylaxis[J]. Clin Gastroenterol Hepatol, 2020, 18(3): 747-749. DOI: 10.1016/j.cgh.2019.05.057.
    [32] YAO X, HUANG S, ZHOU H, et al. Clinical efficacy of antiviral therapy in patients with hepatitis B-related cirrhosis after transjugular intrahepatic portosystemic shunt[J]. World J Gastroenterol, 2021, 27(30): 5088-5099. DOI: 10.3748/wjg.v27.i30.5088.
    [33] PAPATHEODORIDIS GV, MIMIDIS K, MANOLAKOPOULOS S, et al. HERACLIS-TAF: a multi-centre prospective cohort study on 2-year safety and efficacy of tenofovir alafenamide in patients with chronic hepatitis B with renal and/or bone disorders or risks[J]. Aliment Pharmacol Ther, 2022, 56(4): 702-712. DOI: 10.1111/apt.17093.
    [34] SURIAL B, BÉGUELIN C, CHAVE JP, et al. Brief report: switching from TDF to TAF in HIV/HBV-coinfected individuals with renal dysfunction-a prospective cohort study[J]. J Acquir Immune Defic Syndr, 2020, 85(2): 227-232. DOI: 10.1097/QAI.0000000000002429.
    [35] DI PERRI G. Tenofovir alafenamide (TAF) clinical pharmacology[J]. Infez Med, 2021, 29(4): 526-529. DOI: 10.53854/liim-2904-4.
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  • 收稿日期:  2022-07-15
  • 录用日期:  2022-09-19
  • 出版日期:  2023-01-20
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