So sánh kết quả điều trị của tenofovir Alafenamide ở bệnh nhân viêm gan virus B mạn tính có HBeAg (+) và HBeAg (-)

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Tác giả: Thị Hằng Lê, Thị Diệu Ngân Tạ

Ngôn ngữ: Vie

Ký hiệu phân loại: 616.9 Other diseases

Thông tin xuất bản: Truyền nhiễm Việt Nam 2023

Mô tả vật lý: 45518

Bộ sưu tập: Metadata

ID: 409453

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Tóm tắt
Chủ đề

So sánh hiệu quả của TAF tại thời điểm 6 tháng sau điều trị ở nhóm bệnh nhân viêm gan B mạn tính có HBeAg (+) so với nhóm có HBeAg (-). Tìm hiểu mối liên quan của đáp ứng vi rút sau điều trị với một số xét nghiệm. Đối tượng và phương pháp: Nghiên cứu mô tả cắt ngang 49 bệnh nhân điều trị tại Bệnh viện Bạch Mai và Bệnh viện Đại học Y Hà Nội nhằm so sánh kết quả điều trị của TAF tại thời điểm 6 tháng ở bệnh nhân viêm gan B mạn tính có HBeAg (+) và HBeAg (-) và mối liên quan giữa đáp ứng vi rút với các xét nghiệm khác trước điều trị. Kết cục chính về hiệu quả được đánh giá là tỷ lệ đạt đáp ứng virus có HBV DNA <
20 IU/ml (ức chế virus) tại thời điểm tuần 24 sau điều trị. Kết quả: Đáp ứng virus ở nhóm bệnh nhân HBeAg (-) cao hơn rõ rệt so với nhóm HBeAg (+)
77,3% so với 37%, p <
0,05. Không có sự khác biệt về tỉ lệ đáp ứng sinh hóa ở 2 nhóm HBeAg (+) và HBeAg (-). Các bệnh nhân có tải lượng HBV-DNA trước điều trị <
6log (copies/ml) có tỷ lệ đạt đáp ứng virus (dưới ngưỡng phát hiện) cao hơn so với nhóm bệnh nhân có tải lượng HBV-DNA trước điều trị >
8log(copies/ml), 87,5% so với 31,8%, p <
0,05. Không có mối liên quan giữa đáp ứng virus ở thời điểm 6 tháng sau điều trị với nồng độ enzyme ALT ban đầu. Kết luận: Theo dõi bệnh nhân sau 6 tháng điều trị, chúng tôi nhận thấy TAF là thuốc có hiệu quả điều trị cao đối với viêm gan virus B mạn tính. Đặc biệt, ức chế virus cao hơn ở nhóm bệnh nhân có HBeAg (-) so với nhóm bệnh nhân HBeAg (+), Tóm tắt tiếng anh, Tenofovir Alafenamide (TAF) is approved for the treatment of patients with chronic HBV, but the rate of viral response is different between HBeAg-positive and HBeAg-negative patients. A descriptive study on 49 chronic hepatitis B patients treated at Bach Mai Hospital and Hanoi Medical UniversityHospital to compare the effectiveness of TAF in patients with HBeAg (+) and thoses with HBeAg(-) as well as the association between viral response and the laboratory change at baseline of treatment. The primarye൶cacyendpoint was the proportion of patients with HBV DNA less than 20 IU/mL (HBV-DNAsuppression)at week 24 of treatment. Results: The proportion of HBV-DNA suppression in the HBeAg (-) group is significantly higher than in the HBeAg (+) group
77.3% versus 37%, p <
0.05. There was no different about proportionofALTnormalization between HBeAg (+) and HBeAg (-) group. Patients with HBV-DNA at baseline <
6log(copies/mL) have the proportion of viral suppression higher than those with HBV-DNA at baseline >
8log (copies/mL), 87.5% versus 31.8%, p <
0.05. After 6 months of treatment, there was no association between the proportion of viral suppression and the level of ALT at baselin. Conclusions: Following up patients after 6 months of treatment, we found that, Tenofovir Alafenamide had high efficacy for chronic hepatitis B treatment, especially the viral suppression in HBeAg-negative group was better than in HBeAg-positive group.

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