TAF初治CHB合并脂肪肝患者病毒应答时间差异性分析

目的分析富马酸丙酚替诺福韦(TAF)治疗慢性乙型肝炎(CHB)合并脂肪肝患者与治疗单纯CHB患者病毒应答时间的差异性。方法73例使用TAF治疗的CHB患者,均获得病毒应答。其中33例CHB合并脂肪肝患者作为观察组,40例单纯CHB患者作为对照组。比较两组患者的基线资料及病毒应答时间。结果两组患者的性别、年龄、谷丙转氨酶(ALT)、乙型肝炎病毒脱氧核糖核酸(HBV-DNA)(lg)、乙型肝炎表面抗原(lg)、乙型肝炎e抗原阳性率、肝硬度(FS)比较,差异无统计学意义(P>0.05)。两组整体的病毒应答时间均值为30.329周,中位数为25周;观察组病毒应答时间的均值为36.667周,中位数为34周;对照组病毒应答时间的均值为25.100周,中位数为23周;两组病毒应答时间比较,差异具有统计学意义(P<0.05)。结论TAF治疗CHB合并脂肪肝患者至病毒应答所需的时间大于单纯CHB。临床上治疗CHB时,需关注代谢相关脂肪性肝病(MAFLD),并对其进行同步治疗,以提高病毒应答效果。

Analysis of the difference of viral response time of TAF in initial treatment of CHB patients with fatty liver

Objective To analyze the difference in viral response time between the treatment of chronic hepatitis B(CHB)patients with fatty liver and the treatment of simple CHB patients with tenofovir alafenamide(TAF).Methods A total of 73 CHB patients treated with TAF all got viral responses.Among them,33 patients with CHB and fatty liver were taken as the observation group,and 40 patients with simple CHB as the control group.The baseline data and virus response time of the two groups were compared.Results There was no statistically significant difference in gender,age,alanine aminotransferase(ALT),hepatitis B virus deoxyribonucleic acid(HBV-DNA)(lg),hepatitis B surface antigen(lg),hepatitis B e antigen positive rate,and stiffness(FS)between the two groups(P>0.05).The overall mean viral response time of the two groups was 30.329 weeks,and the median was 25 weeks;the mean viral response time of the observation group was 36.667 weeks,and the median was 34 weeks;the mean viral response time of the control group was 25.100 weeks,the median was 23 weeks.There was statistically significant difference in virus response time between the two groups(P<0.05).Conclusion The viral response time of TAF treatment of CHB patients with fatty liver is longer than that of CHB alone.In the clinical treatment of CHB,it is necessary to pay attention to metabolic-associated fatty liver disease(MAFLD)and perform simultaneous treatments to improve the response of the virus.