从富马酸替诺福韦二吡呋酯(TDF)到替诺福韦阿拉非酰胺(TAF):儿科患者的视角。

IF 4.2 2区 医学 Q1 INFECTIOUS DISEASES Expert Review of Anti-infective Therapy Pub Date : 2024-10-03 DOI:10.1080/14787210.2024.2412991
Minna Rodrigo, Christopher Hartley, Trung Van, Paul Wasuwanich, Wikrom Karnsakul
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引用次数: 0

摘要

导言:乙型肝炎病毒(HBV)影响着全球数亿人,其中许多病例源于围产期传播。儿童慢性乙型肝炎(CHB)成年后可发展为肝硬化和肝细胞癌(HCC)。治疗方案包括干扰素和核苷(t)ide 逆转录酶抑制剂(N[t]RTIs),如替诺福韦阿拉非酰胺(TAF):本综述涵盖了儿科慢性阻塞性肺病的流行病学和当前的治疗方法,重点是基于替诺福韦的疗法,尤其是富马酸替诺福韦二吡呋酯(TDF)和TAF。TDF已使用多年,但其骨质密度下降和肾功能损害的风险引起了人们的关注。TAF的全身暴露较低,似乎可以减轻这些风险。正在进行的试验正在评估TAF对年幼儿童的安全性。在长期安全性和联合疗法的潜力方面还存在知识空白:TAF为CHB患儿提供了比TDF更安全的替代药物,显示出较高的抗病毒疗效和较少的副作用。专家观点:TAF为CHB患儿提供了更安全的替代品TDF,具有较高的抗病毒疗效和较少的副作用,但还需要更多关于其在年龄较小患儿中的使用和长期安全性的数据。儿科 CHB 治疗的未来可能包括联合疗法和个性化方法,从而有可能改善疗效,并将终生治疗的风险降至最低。随着研究的深入,TAF 有可能成为儿科 CHB 治疗的基石。
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From tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF): perspectives in pediatric patients.

Introduction: Hepatitis B virus (HBV) affects hundreds of millions globally, with many cases stemming from perinatal transmission. Chronic hepatitis B (CHB) in children can progress to cirrhosis and hepatocellular carcinoma (HCC) in adulthood. Treatment options include interferons and nucleos(t)ide reverse transcriptase inhibitors (N[t]RTIs) such as tenofovir alafenamide (TAF).

Areas covered: This review covers the epidemiology of pediatric CHB and current treatments, with a focus on tenofovir-based therapies, particularly tenofovir disoproxil fumarate (TDF) and TAF. TDF has been used for years, but its risks of bone mineral density loss and renal impairment have raised concerns. TAF, with lower systemic exposure, appears to mitigate these risks. Ongoing trials are evaluating TAF's safety in younger children. There are knowledge gaps in long-term safety and the potential for combination therapies.

Expert opinion: TAF offers a safer alternative to TDF for children with CHB, showing high antiviral efficacy and fewer side effects. However, more data is needed on its use in younger children and long-term safety. The future of CHB treatment in pediatrics may include combination therapies and personalized approaches, potentially improving outcomes and minimizing risks over a lifetime of treatment. As research progresses, TAF is likely to become a cornerstone in pediatric CHB management.

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来源期刊
CiteScore
11.20
自引率
0.00%
发文量
66
审稿时长
4-8 weeks
期刊介绍: Expert Review of Anti-Infective Therapy (ISSN 1478-7210) provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.
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