ABSTRACT
Objective To compare the efficacy and safety of tenofovir disoproxil fumarate ( TDF) and entecavir(ETV) in the treatment of chronic hepatitis B(CHB) with positive hepatitis B E antigen(HBeAg). Methods A total of 104 cases with newly diagnosed HBeAg positive CHB were selected and randomly divided into TDF group and ETV group,with 52 cases in each group. The TDF group was given 300mg/d TDF,and the ETV group was given 0. 5mg/d ETV. All the patients were continuously treated for 12 months. The serum HBV DNA, HBeAg and ALT levels before and after treatment were compared between the two groups. Results Before treatment,there were no statistically significant differences in serum HBV DNA,HBeAg and ALT levels between the two groups ( t=0. 12, 1. 51,1. 62,all P＞0. 05). The serum HBV DNA,HBeAg and ALT levels in the two groups were decreased after treatment,and the decrease of serum HBV DNA level in the TDF group was more significant than that in the ETV group,the difference was statistically significant(t =3. 54,P ＜0. 05),but there were no statistically significant differences in serum HBeAg and ALT levels between the two groups(t=0. 04,0. 79,all P＞0. 05). The total effective rate of the TDF group was 92. 31% (48/52),which was significantly higher than 76. 92% (40/52) in the ETV group (χ2=4. 73,P＜0. 05). During treatment,the incidence rate of adverse reaction of the TDF group was 7. 69% (4/52),which was lower than 11. 54% (6/52) of the ETV group,but the difference was not statistically significant (χ2=0. 44,P＞0. 05). Conclusion TDF has better clinical effect in treating newly diagnosed HBeAg positive CHB than ETV due to TDF can inhibit HBV DNA replication significantly,but the safety of TDF and ETV is similar.