Potent Antiviraller Arasında Fark Var mı? Tenofovir ve Entekavirin Noninvaziv Biyobelirteçler Üzerindeki 5 Yıllık Etkilerinin Karşılaştırılması

Amaç: Kronik karaciğer hastalıklarının morbidite ve mortalitesi karaciğer fibrozisinin derecesi ile yakından ilişikilidir. Karaciğer fibrozisinin artık geri dönüşümlü olduğu ve tedavi ile geri döndürülebildiği bilinmektedir. Bu çalışmada, kronik hepatit B hastalarındaki fibrozisin gerilemesinde potent antivirallerin etkinliği non-invaziv testler üzerinde araştırılmış; şayet iyileşme yönünde etkinlikleri varsa aralarında bir farkın olup olmadığını araştırılmıştır.Gereç ve Yöntem: Karaciğer biyopsisi yapılan kronik hepatit B hastalarının tıbbi kayıtları sistematik olarak incelendi ve uygunluk açısından tarandı. Potent antiviral tedavi başlanan ve 5 yıl boyunca alan naif hastalar seçildi. Bu hastaların çalışılan non-invaziv biyobelirteçlerinin (AAR, API, APRI, FIB-4, PLT, MPV) başlangıç, 3. yıl ve 5. yıl değerleri karşılaştırıldı.Bulgular: Tenofovir ve entecavir alan hastalarda APRI, AAR, API, MPV ve PLT dağılımları açısından 3 ölçüm arasında istatistiksel olarak anlamlı bir fark vardı (Friedman p <0,05). Bazal ve 3. yıl, bazal ve 5. yıl değerleri arasında APRI, AAR, API, MPV ve PLT ölçümleri açısından post-hoc ikili karşılaştırmalara göre istatistiksel olarak anlamlı bir fark vardı (Wilcoxon p <0,016 Bonferroni düzeltmesi). Bu değerlerdeki iyileşme açısından iki ilaç arasında belirgin bir fark saptanmadı (Mann-Whitney U, p>0,05). Sonuç: Kronik karaciğer hastalıklarının tanısında ve tedavi takibinde karaciğer biyopsisinin altın standart olduğu bilinmektedir. Bununla birlikte, biyopsi her zaman mümkün olmayabilir. Verilen tedavinin karaciğer histopatolojisi üzerinde yaptığı iyileşmeyi takip edebilmek için invaziv olmayan birkaç test kullanılabilir. Kr hepatit B hastalarında fibrozisteki iyileşme üzerinde potent antiviraller etkin ancak bu etkinlik açısından aralarında fark yoktur.

Anahtar Kelimeler:

Entekavir, Fibrozis, Kr hepatit B, Noninvaziv test, Tenofovir

IS THERE A DIFFERENCE BETWEEN POTENT ANTIVIRALS? COMPARISON OF 5-YEAR CHANGES OF TENOFOVIR AND ENTECAVIR ON NONINVASIVE MARKERS

Objective: The morbidity and mortality of chronic liver diseases are closely related to the degree of liver fibrosis. It is known that liver fibrosis is now reversible and can be reversed with treatment. In this study, the effectiveness of potent antivirals in the regression of fibrosis in chronic hepatitis B patients was investigated on non-invasive tests; if there is a difference between them, it is investigated whether there is a difference between them.Materials and Methods: Medical records of chronic hepatitis B patients who underwent liver biopsy were systematically reviewed and screened for compliance. Potent antiviral treatment was initiated and selected naive patients who received for 5 years. The non-invasive biomarkers (AAR, API, APRI, FIB-4, PLT, MPV) of these patients were compared at baseline, 3rd year and 5th year.Results: There was a statistically significant difference in APRI, AAR, API, MPV and PLT distributions between ten measurements in tenofovir and entecavir patients (Friedman p <0.05). There was a statistically significant difference between baseline and 3rd year, baseline and 5th year values in terms of APRI, AAR, API, MPV and PLT measurements compared to post-hoc binary comparisons (Wilcoxon p <0.016 Bonferroni correction). There was no significant difference between these two drugs in terms of improvement in these values (Mann-Whitney U, p> 0.05). Conclusion: It is known that liver biopsy is the gold standard in the diagnosis and follow-up of chronic liver diseases. However, biopsy may not always be possible. Several non-invasive tests can be used to monitor the improvement of treatment on liver histopathology. Potential antivirals are effective on the recovery of fibrosis in patients with chronic hepatitis B, but there is no difference in this efficacy.

Keywords:

Entecavir, Fibrosis, Hepatitis B, Non-invasive tests, Tenofovir,

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