Prevention of liver dysfunction during anti-tuberculosis treatment in chronic hepatitis B virus infected patients complicated with tuberculosis / 中华临床感染病杂志

ABSTRACT

Objective To evaluate the preventive effect of entecavir on liver injury in chronic HBV infected patients complicated with tuberculosis receiving anti-tuberculosis treatment.Methods A total of 102 chronic HBV infected patients complicated with tuberculosis were collected from Guangzhou Eighth People' s Hospital and Guangzhou Chest Hospital during January 2011 and May 2012.Patients were divided into three groupsgroup A (n =33) received entecavir plus anti-tuberculosis treatment,group B (n =29) received lamivudine plus anti-tuberculosis treatment,and group C (n =40) received anti-tuberculosis treatment only.Liver injury,termination of treatment,liver function and HBV DNA load before and after treatment were observed.SPSS 13.0 was used for statistial analysis.Results Two cases (6.1％) in group A,6 cases (20.6％) in group B and 22 cases (55.0％) in group C had liver injury,and the difference among three groups was of statistical difference (x2 =22.126,P ＜ 0.01),but the difference between group A and group B was not significant (x2 =3.024,P＞0.05).One case (3.0％) in group A,3 cases (10.3％) in group B and 15 cases (37.5％) in group C terminated the treatment,and the difference among three groups was of statistical significance (x2 =16.008,P ＜ 0.01),but the difference between group A and group B was not significant (x2 =1.410,P ＞0.05).ALT and AST in group A and group B were not of significant differences before and after anti-tuberculosis treatment,but those in group C were significantly higher (Z =18.306,16.821,P ＜ 0.01).There was no significant difference in HBV DNA load among three groups before the treatment (Z =0.460,P ＞ 0.05),while HBV DNA loads in group A and group B significantly decreased during the treatment,and the difference among three groups after the treatment was significant (Z =23.213,P ＜0.01).In addition,lower HBV DNA load was observed in group A compared with group B after one month anti-tuberculosis treatment (Z =8.109,P ＜ 0.01).Conclusion Early use of entecavir can effectively prevent liver injury during anti-tuberculosis treatment,ensuring anti-tuberculosis treatment and anti-HBV treatment carried out as planned.