The Efficacy and Safety of Different Antiviral Treatment Regimens in Patients with ALT Elevation and Low Viral Load in the Indeterminate Phase of Chronic Hepatitis B

Ti WU; Kang HUANG; Zhirong ZHAO; Haiwen LI; Xiaofei LI; Yongrui YANG

doi:10.12259/j.issn.2095-610X.S20230117

Volume 44 Issue 1

Jan. 2023

Turn off MathJax

Article Contents

Article Navigation > Journal of Kunming Medical University > 2023 > 44(1): 97-103

Ti WU, Kang HUANG, Zhirong ZHAO, Haiwen LI, Xiaofei LI, Yongrui YANG. The Efficacy and Safety of Different Antiviral Treatment Regimens in Patients with ALT Elevation and Low Viral Load in the Indeterminate Phase of Chronic Hepatitis B[J]. Journal of Kunming Medical University, 2023, 44(1): 97-103. doi: 10.12259/j.issn.2095-610X.S20230117

Citation:

Ti WU, Kang HUANG, Zhirong ZHAO, Haiwen LI, Xiaofei LI, Yongrui YANG. The Efficacy and Safety of Different Antiviral Treatment Regimens in Patients with ALT Elevation and Low Viral Load in the Indeterminate Phase of Chronic Hepatitis B[J]. Journal of Kunming Medical University, 2023, 44(1): 97-103. doi: 10.12259/j.issn.2095-610X.S20230117

Citation:

Ti WU, Kang HUANG, Zhirong ZHAO, Haiwen LI, Xiaofei LI, Yongrui YANG. The Efficacy and Safety of Different Antiviral Treatment Regimens in Patients with ALT Elevation and Low Viral Load in the Indeterminate Phase of Chronic Hepatitis B[J]. Journal of Kunming Medical University, 2023, 44(1): 97-103. doi: 10.12259/j.issn.2095-610X.S20230117

PDF( 745 KB)

The Efficacy and Safety of Different Antiviral Treatment Regimens in Patients with ALT Elevation and Low Viral Load in the Indeterminate Phase of Chronic Hepatitis B

doi: 10.12259/j.issn.2095-610X.S20230117

Ti WU¹,
Kang HUANG¹,
Zhirong ZHAO²,
Haiwen LI²,
Xiaofei LI^{2
,
,},
Yongrui YANG^{2
,
,}

1.
School of Public Health，Dali University，Dali Yunnan 671000
2.
Dept. of Hepatology，The 3rd People’s Hospital of Kunming，Kunming Yunnan 650041，China

Received Date: 2022-11-05
Available Online: 2022-12-24
Publish Date: 2023-01-18

Abstract

Abstract

Objective To observe the clinical efficacy and safety of first-line nucleos （t）ide analogues antiviral therapy in newly diagnosed chronic hepatitis B patients with low viral load and uncertain stage. Methods A total of 96 diagnosed treatment-naive chronic hepatitis B patients with low viral load in indeterminate stage who attended Kunming Third People’s Hospital from January 2019 to April 2022 were included and divided into the ETV group, TDF group and TAF group according to the drugs used. The differences in clinical efficacy and safety of the three groups were observed at the 12thW, 24thW and 48thW of continuous dosing. Results After 48 weeks of the antiviral treatment, a total of 96.88% （93/96） patients achieved complete virologic response （CVR, defined as HBV DNA < 100 IU/mL） to HBV DNA, with CVR rates in the three groups: 96.97% （32/33） in the ETV group, 96.97% （32/33） in the TDF group 96.97% （32/33）, and 96.67% （29/30） in the TAF group, with no statistically significant difference among the three groups （P = 0.997）. HBsAg levels decreased significantly at 48 weeks of treatment compared to the baseline in all three groups, but there was no statistically significant difference among the three groups （P = 0.348）. eGFR levels were significantly elevated in the TAF group compared to those in the ETV group （P = 0.013） and the TDF group （P = 0.047）, and AFP levels decreased significantly compared to those in the ETV group （P = 0.008） and the TDF group （P = 0.007）. There was no significant difference of ALT recurrence rate for 48 weeks among TAF group （70%）, TDF group （45.45%） and ETV group （60.61%）（P = 0.135）. No serious adverse events occurred during the treatment period. Conclusion The CVR rate of all three groups has reached more than 96% after 48 weeks of the treatment, the ALT normalization rate of the TAF group is better than that of the TDF group, and the decrease in AFP level and improvement in eGFR level of the TAF group are better than those of the ETV and TDF groups. The patients with elevated ALT and low viral load in the indeterminate phase of chronic hepatitis B could benefit from antiviral therapy.
- Antiviral therapy,
- Low viral load chronic hepatitis B,
- Indeterminate phase

FullText(HTML)

References(12)

References

[1]	王贵强, 王福生, 庄辉, 等. 慢性乙型肝炎防治指南（2019年版）[J/OL]. 中国病毒病杂志, 2020, 10（1）: 1-25.
[2]	张会,王欣茹,肖丽,等. 不确定期慢性HBV感染者的分布与治疗[J]. 临床肝胆病杂志,2021,37(12):2778-2779. doi: 10.3969/j.issn.1001-5256.2021.12.008
[3]	Sinn D H, Kim S E, Kim B K, et al. The risk of hepatocellular carcinoma among chronic hepatitis B virus‐infected patients outside current treatment criteria[J/OL]. Journal of Viral Hepatitis, 2019, 26（12）: 1465-1472.
[4]	中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎临床治愈（功能性治愈）专家共识[J]. 中华临床感染病杂志, 2019, 27（8）: 594-603.
[5]	Zoutendijk R, Reijnders J G, Zoulim, et al. Virological response to entecavir is associated with a better clinical outcome in chronic hepatitis B patients with cirrhosis[J/OL]. Gut, 2013, 62（5）: 760-765.
[6]	Huang D Q, Li X, Le M H, et al. Natural history and hepatocellular carcinoma risk in untreated chronic hepatitis B patients with indeterminate phase[J/OL]. Clinical Gastroenterology and Hepatology, 2022, 20（8）: 1803-1812. e5.
[7]	Spradling P R, Xing J, Rupp L B, et al. Distribution of disease phase, treatment prescription and severe liver disease among 1598 patients with chronic hepatitis B in the Chronic Hepatitis Cohort Study, 2006-2013[J/OL]. Alimentary Pharmacology & Therapeutics, 2016, 44（10）: 1080-1089.
[8]	Jang J W, Choi J Y, Kim Y S, et al. Effects of virologic response to treatment on short- and long-term outcomes of patients with chronic h epatitis B virus infection and decompensated cirrhosis[J/OL]. Clinical Gastroenterology and Hepatology, 2018, 16（12）: 1954-1963. e3.
[9]	Chan H L Y, Fung S, Seto W K, et al. Tenofovir alafenamide versus tenofovir disoproxil fumarate for the treatment of HBeAg-positive chronic hepatitis B virus infection: a randomised, double-blind, phase 3, non-inferiority trial[J/OL]. The Lancet Gastroenterology & Hepatology, 2016, 1（3）: 185-195.
[10]	Choi J, Kim H J, Lee J, et al. Risk of hepatocellular carcinoma in patients treated with entecavir vs tenofovir for chronic hepatitis B: A Korean nationwide cohort study[J/OL]. JAMA Oncology, 2019, 5（1）: 30.
[11]	Choi W M, Choi J, Lim Y S. Effects of tenofovir vs entecavir on risk of hepatocellular carcinoma in patients with chronic HBV infection: A systematic review and Meta-analysis[J/OL]. Clinical Gastroenterology and Hepatology, 2021, 19（2）: 246-258. e9.
[12]	庄辉. 不确定期慢性乙型肝炎应否治疗[J]. 临床肝胆杂志,2021,37(9):2033-2036.

Relative Articles(20)

Relative Articles

[1]	Yihan LIU, Jun LIU, Yongmei JIN, Bo TIAN, Jinsong BAI. Risk Assessment and Analysis of Risk Factors for Cardiovascular Disease in HIV Antiviral Therapy Patients. Journal of Kunming Medical University, 2024, 45(10): 140-146. doi: 10.12259/j.issn.2095-610X.S20241022
[2]	Bo TIAN, Yongmei JIN, Haiwen LI, Chongxi LI, Wei ZHANG, Wei GUAN, Haiyun CHEN, Qi XUE, Huirong YANG, Jun LIU. Analysis of the Current Status and Influencing Factors of Metabolic Syndrome in Patients Undergoing Antiretroviral Therapy for AIDS. Journal of Kunming Medical University, 2024, 45(11): 1-6.
[3]	Xuelin XIANG, Hongrui ZHAO, Zhongjie WANG, Yu XIA, Min MA, Huadan WANG, Liping. HE. Social Support Status and Influencing Factors of HIV-infected Patients on Antiviral Therapy. Journal of Kunming Medical University, 2024, 45(9): 156-162. doi: 10.12259/j.issn.2095-610X.S20240924
[4]	Hongrui ZHAO, Xuelin XIANG, Zhongjie WANG, Yu XIA, Huadan WANG, Min MA, Liping HE. Analysis of Influencing Factors of Perceived Discrimination in HIV-infected Patients Treated with Antiviral Therapy. Journal of Kunming Medical University, 2024, 45(12): 1-6.
[5]	Bo TIAN, Jun LIU, Chongxi LI, Wei ZHANG, Meiqin FANG, Haiyun CHEN, Jingping BAI, Xin ZHOU, Lei CHENG, Yongmei JIN. Effect Observation and Influencing Factors Analysis of Rapid Initiation of Antiretroviral Therapy. Journal of Kunming Medical University, 2024, 45(9): 163-167. doi: 10.12259/j.issn.2095-610X.S20240925
[6]	Dong PU, Tingting YU, Lihua LI, Runwu ZHANG, Kunli WU, Dongling LI. Analysis of Serum High-sensitivity HBV DNA in Patients with Chronic Hepatitis B with Low Viral Load in Kunming Area. Journal of Kunming Medical University, 2023, 44(1): 116-121. doi: 10.12259/j.issn.2095-610X.S20230114
[7]	Xiaomei JIN, Jieyan HE, Jichang SHI, Hui XING, Hong WANG, Ju ZHANG, Lijuan DONG, Lihua HUANG, Min CHEN, Zhijuan CHEN, Huichao CHEN. Virus Genotypes and Drug Resistance among HIV/AIDS Patients before Antiretroviral Therapy in Dali Bai Autonomous Prefecture in 2018. Journal of Kunming Medical University, 2023, 44(11): 152-157. doi: 10.12259/j.issn.2095-610X.S20231123
[8]	Bo TIAN, Chongxi LI, Yongmei JIN, Wei GUAN, Haiyun CHEN, Jun LIU. Use and Replacement of Treatment Regimens for AIDS Patients on Antiretroviral Therapy. Journal of Kunming Medical University, 2023, 44(5): 162-167. doi: 10.12259/j.issn.2095-610X.S20230508
[9]	Diandian ZENG, Bo TIAN, Yongmei JIN, Chongxi LI, Fen TENG, Jun LIU. A Cross-sectional Survey on Quality of Life of AIDS Patients with Different Antiretroviral Regimens in Kunming Area. Journal of Kunming Medical University, 2022, 43(12): 147-152. doi: 10.12259/j.issn.2095-610X.S20221227
[10]	Chongxi LI, Guangfeng YIN, Yushu ZHANG, Shanqun GU, Wei ZHANG, Jun LIU, Bo TIAN. Prevalence of Kidney Disease among Pre-ART Patients with HIV Infection in Kunming and The Influencing Factors. Journal of Kunming Medical University, 2022, 43(2): 154-159. doi: 10.12259/j.issn.2095-610X.S20220208
[11]	Tingting YU, Hongying WANG, Runwu ZHANG, Jing BAI, Dong PU, Dongling LI. Analysis of Drug Resistance Mutation-related Sites in 1 452 Chronic Hepatitis B Patients with Low Viral Load in Kunming Area. Journal of Kunming Medical University, 2022, 43(9): 43-47. doi: 10.12259/j.issn.2095-610X.S20220927
[12]	Shan HUANG, Song-qin LV, Hong-fen DUAN, Jin-li SHI, Guang-min LI, Gang HUANG, Jia-neng LI, Xiao-fei LI. Cohort Study on the Influence of Opportunistic Infectious Pathogens on the Distribution of Peripheral Blood T Lymphocyte Subsets in Newly Acquired AIDS Patients During Antiretroviral Therapy. Journal of Kunming Medical University, 2021, 42(11): 159-165. doi: 10.12259/j.issn.2095-610X.S20211128
[13]	Yong-rui YANG, Hai-wen LI, Zhi-rong ZHAO, Lu WANG, Ting JIA, Zhi-jian DONG, Xiao-fei LI, Ni-hong LU. Clinical Efficacy and Safety of Sofosbuvir and Vipatavir in the Treatment of Patients with Chronic Hepatitis C and HCV/HIV co-infection. Journal of Kunming Medical University, 2021, 42(7): 130-136. doi: 10.12259/j.issn.2095-610X.S20210722
[14]	Ting-ting YU, Xiao-fei LI, Hong-ying WANG, Run-wu ZHANG, Cai-mei DING, Li-hua LI, Jing BAI, Dong-ling LI, Dong PU. Application of Viral Load Testing in Diagnosing 102 Cases of Indeterminate HIV Antibody. Journal of Kunming Medical University, 2020, 41(11): 130-133. doi: 10.12259/j.issn.2095-610X.S20201126
[15]	Li Zhong Xi , Liu Jun , Bai Jing Song , Tian Bo , Yu Min , Gu Shan Qun . . Journal of Kunming Medical University, 2019, 40(01): 92-95.
[16]	Yang Yong Rui , Li Xiao Fei , Liu Jun , Guo Ying Wu , Shen Ling . . Journal of Kunming Medical University, 2018, 39(11): 110-113.
[17]	Lou Jin Cheng , Wu Xin Hua , Chen Xi , Lei Hong Tao , Li Tian Shu , An Liang, Lao Yun Fei . An investigation on the Dropout of Patients with HIV/AIDS Receiving Antiviral Therapy in an Area of Yunnan Province. Journal of Kunming Medical University, 2018, 39(04): 121-124.
[18]	Yang Yong Rui , Li Fei , Yang Yin , Wen Pin Yuan , Feng Yu , Shen Jiu Cheng , Zhang Jian Qing , Shen Ling . . Journal of Kunming Medical University, 2018, 39(10): 126-129.
[19]	Yang Yong Rui . . Journal of Kunming Medical University,
[20]	Zhou Gui . . Journal of Kunming Medical University,