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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
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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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