Effect of Hepatosteatosis on the Virological Response in Entecavir and Tenofovir Therapies

P. Korkmaz, N. Demirturk, A. Batırel, N. Tulek, M. Ozguler, R. Harman, G. Cınar, O. Toka, Gulsen Yoruk, C. Ataman-Hatipoglu, Figen Sarigul, F. Sırmatel, Ayfer İmre, Duru Mistanoğlu-Ozatag, F. Karakeçili, O. Ural, S. Sumer, Nazlım Aktug-Demir, A. Kadanalı, Ş. Çomoğlu, S. Ucer, N. Saltoğlu, Ö. Günal, H. D. Ozkaya, E. Yenilmez, R. Çetinkaya, E. Yüksel, I. Hakyemez, M. Meriç-Koç, Gunay Tuncer-Ertem, Zehra Bestepe-Dursun, I. Çelik, E. Yılmaz, Güliz Evik, A. Kaya, K. Suer, Tip Fakultesi Biyoistatistik Anabilim Dali Ankara Turk Hacettepe Universitesi
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Abstract

Objective: Both chronic hepatitis B (CHB) and hepatosteatosis may lead to necroinflammation in liver. Therefore, the presence of hepatosteatosis might negatively affect the efficacy of antiviral therapy. We aimed to determine the effect of hepatosteatosis on virological response in patients with CHB receiving entecavir (ETV) and tenofovir (TDF) treatment. Methods: The study was designed retrospectively. All patients receiving antiviral therapy due to CHB in the departments of Infectious Diseases and Clinical Microbiology of 29 different hospitals between January 2012 and June 2017 were searched by examining medical records. Results: A total of 1069 patients were included. Six hundred and fifty of the patients had been receiving TDF and 419 of them had been receiving ETV. The rate of virological response obtained at the 48th week of TDF was higher in patients with steatosis (p=0.029). Virological response at the 24th week and 48th week of ETV were higher in the patients without steatosis (p=0.001). TDF and ETV therapies were compared in the patients with hepatosteatosis and it was found that the virological response at 48th week was higher in the TDF group. Conclusion: Although steatosis has an effect on virological response in the short-term results of nucleos(t)ide therapy, it does not have any effect on virological response in the long-term results. Klimik Dergisi 2019; 32(3): 265-74.
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恩替卡韦和替诺福韦治疗中肝纤维化对病毒学反应的影响
目的:慢性乙型肝炎(CHB)和肝骨赘病均可导致肝脏坏死性炎症。因此,肝骨赘病的存在可能会对抗病毒治疗的效果产生负面影响。我们的目的是确定肝细胞增生对接受恩替卡韦(ETV)和替诺福韦(TDF)治疗的慢性乙型肝炎患者病毒学反应的影响。方法:采用回顾性设计。通过查阅病历,检索了2012年1月至2017年6月29家不同医院感染性疾病和临床微生物科因CHB接受抗病毒治疗的所有患者。结果:共纳入1069例患者。650例患者接受TDF治疗,419例接受ETV治疗。脂肪变性患者在TDF治疗第48周获得的病毒学应答率更高(p=0.029)。未发生脂肪变性的患者在ETV第24周和第48周的病毒学应答较高(p=0.001)。比较TDF和ETV治疗肝纤维化患者,发现TDF组48周病毒学应答更高。结论:虽然脂肪变性对核苷治疗的短期结果的病毒学应答有影响,但对长期结果的病毒学应答没有任何影响。Klimik Dergisi 2019;32(3): 265 - 74。
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