替诺福韦酯治疗慢性乙型肝炎

Patrick Marcellin
Hopital Beaujon, Clichy, France

On the third day of APSAL, Professor Patrick Marcellin made a report titled ” How will Tenofovir Change the Choice of Anti-viral Agents”. In this study, patients with HBeAg-positive (+) or –negative (-) CHB were randomized to double-blind, tenofovir disoproxil fumarate (TDF) or adefovir dipivoxil (ADV). After 48 weeks, patients rolled to open-label (OL) TDF for an additional 7 years. The results up to week 96 are as follows: HBeAg+: At W96, viral suppression on ADV was maintained/enhanced after rolling to TDF (ADV-TDF): 100% of stable and 82% viremic patients on ADV had HBV DNA <400 copies (c)/mL at W96. In an intent-to-treat (ITT) analysis, 78% of ADV-TDF patients had HBV DNA <400 c/mL at W96, as the same as the percentage in TDF-TDF patients. 27% (TDF-TDF) and 22% (ADV-TDF) HBeAg seroconverted (p=0.31). 6% in both groups experienced HBsAg loss. One patient discontinued due to an adverse event. And the groups of HBeAg- had the similar conclusions.

Professor Patrick Marcellin concluded that TDF produced potent, continuous viral suppression and was well tolerated through week 96. Patients rolling to TDF after 48 weeks of ADV treatment benefited with significant additional viral suppression and had a similar response to patients treated with TDF for 96 weeks.
                 
在APASL大会第3天，Patrick Marcellin教授做了题为“How will Tenofovir Change the Choice of Anti-viral Agents”的大会报告。这项研究针对HbeAg（+）或（-）慢性乙型肝炎患者，随机双盲分为替诺福韦酯（TDF）及阿德福韦酯（ADV）组治疗48周后，均替换为TDF继续治疗7年。Patrick Marcellin教授报告了在HBeAg阳性及阴性患者96周的观察中，TDF可产生有效、持续的病毒抑制，并且耐受性良好。ADV治疗48周后换为TDF的患者获得了有显著性意义的额外病毒抑制，在第96周时与TDF治疗96周的患者相比有相似的应答。