Antiviral curative effects of tenofovir and entecavir in treatment of aged patients with chronic hepatitis B and their regulation on inflammation factors / 吉林大学学报(医学版)

ABSTRACT

Objective:To compare the clinical efficacies of tenofovir (TDF) and entecavir (ETV) in the treatment of the aged patients with chronic hepatitis B (CHB) and their regulation on the inflammation factors, and to provide basis for their clinical application.Methods:A total of 93aged patients with CHB were selected and randomly divided into TDF group (n=48) and ETV group (n=45) .And the patients were treated with TDF (300mg/time, 1time·d-1) and ETV (0.5mg/time, 1time·d-1) ;the patients in two groups were observed for continuous 48 weeks.The levels of serum hepatitis B virus-deoxyribonucleic acid (HBV-DNA) , glutamic pyruvic transaminase (ALT) , and tumor necrosis factorα (TNF-α) , interleukin-10 (IL-10) , the ALT recovery rates, the HBV-DNA negative conversion rates, and the HBeAg negative rates of the patients in two groups were detected before treatment and 4, 12, 24, 36and 48weeks after treatment, respectively.Results:Compared with before treatment, the levels of serum HBV-DNA and ALT of the patients in two groups after treatment were decreased (P＜0.05) ;the levels of serum HBV-DNA and ALT of the patients in TDF group were significantly lower than those in ETV at 4and 12weeks after treatment (P＜0.05) .Compared with before treatment, the levels of serum TNF-αand IL-10of the patients in two groups after treatment were significantly decreased, and there were statistically significant differences between two groups at 12weeks after treatment (P＜0.05) .After treatment, the ALT recovery rates of the patients in two groups were increased gradually;the ALT recovery rates in TDF group were significantly higher than those in ETV group (P＜0.05) at 4and 12weeks after treatment.The patients in two groups showed complete virological responses at 4 weeks after treatment, and the HBV-DNA negative conversion rates were increased gradually.The negative conversion rates of HBV-DNA in TDF group were significantly higher than those in ETV group (P＜0.05) at 4, 12and 24 weeks after treatment.The negative conversion of HBeAg in TDF group appeared at 12weeks, which was earlier than that in ETV group;the negative conversion of HBeAg in ETV group appeared at 24weeks;there was no significant difference in HBeAg negative conversion rate between two groups (P＞0.05) .Conclusion:Both TDF and ETV could be used to treat the aged patients with CHB.TDF has earlier antiviral effect and can bring quick recovery in liver function with lighter inflammatory reaction.TDF is an ideal antiviral drug for clinical treatment.