Kronik hepatit B hastalarında potent antiviral tedavinin değerlendirilmesi

Amaç: Kronik Hepatit B (KHB) enfeksiyonunda tedavinin amacı; kalıcı viral süpresyon, biyokimyasal ve histolojik düzelmenin sağlanması, siroz ve/veya hepatosellüler karsinom gibi uzun dönem komplikasyonlarını önlemektir. Güncel tedavide Tenofovir disoproksil, Tenofovir alafenamid ve Entekavir en potent ilaçlardır. Bu ilaçların uzun süre etkinliğine yönelik gerçek yaşam verilerinin sunulduğu çalışmalar sınırlıdır. Bu çalışmada uzun süre Tenofovir disoproksil ve Entekavir tedavisi alan hastaların geriye yönelik etkinliğinin değerlendirilmesi planlandı. Yöntem: Çalışmada 2007-2015 yılları arasında KHB tanısı almış olan, oral antiviral tedavi almamış olan ve Entekavir (0.5 mg/gün) veya Tenofovir disoproksil (245 mg/gün) alan hastaların dosyaları retrospektif olarak değerlendirildi. Hastalarda en az altı ay tedavi almaları ölçüt olarak alındı. Dekompanze sirozu, malignite ve diğer altta yatan hastalığı olanlar değerlendirilme dışı bırakıldı. Tedavi yanıtlarının değerlendirilmesinde; HBV DNA düzeyi, ALT değerleri, serokonversiyon durumu analiz edildi. Bulgular: Tek merkezde takip edilen, KHB tanılı daha önce antiviral tedavi almamış olan 111 hasta TDF (n=54, %57 erkek, yaş ortalaması 44±14 y, %27 HBeAg pozitif, takip süresi median 38 ay) ve ETV (n=57, %51 erkek, ortalama yaş 46±13 y,% 18 HBeAg pozitif, takip süresi median 48 ay) olmak üzere iki farklı grup tedavi rejimi almıştır. TDF grubunda başlangıçtaki HBV DNA değeri (8.0±1,1 kopya/mL) ETV grubundan (7.7±1.1 kopya/mL) daha büyük ve anlamlıydı (p=0.02). İki tedavi grubunda tedavinin altıncı ve 12. aylarında HBV DNA negatifliği karşılaştırıldığında, ETV grubunda istatistiksel olarak anlamlı HBV DNA negatifliğinin elde edildiği görüldü (p

Anahtar Kelimeler:

Kronik Hepatit B, Entekavir, tenofovir

Evaluation of potent antiviral therapy in chronic hepatitis B patients

Keywords:

Kronik Hepatit B, entekavir, tenofovir,

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