Comparative role of tenofovir versus entecavir for treating patients with hepatitis B virus-related acute on chronic liver failure.

Autor: Hossain SMS; Department of Medicine, Kurmitola General Hospital, Dhaka, Bangladesh., Mahtab MA; Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh., Das DC; Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh., Noor-E-Alam SM; Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh., Mamun AA; Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh., Khan MSI; Department of Anatomy and Embryology, Ehime University Graduate School of Medicine, Ehime, Japan., Akbar SMF; Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan., Rahman MZ; Department of Primary Care and Microbiology, Brahminbaria Medical College, Brahminbaria, Bangladesh., Rahman S; Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Jazyk: angličtina
Zdroj: Journal of family medicine and primary care [J Family Med Prim Care] 2021 Jul; Vol. 10 (7), pp. 2642-2645. Date of Electronic Publication: 2021 Jul 30.
DOI: 10.4103/jfmpc.jfmpc_2299_20
Abstrakt: Introduction: The aim of the study was to compare the safety and efficacy of tenofovir versus entecavir for treatment of naive acute on chronic liver failure (ACLF) due to hepatitis B virus (HBV) (ACLF-B).
Methods: Thirty-two patients aged 14-65 years were enrolled in the study. Diagnosis of ACLF was confirmed by clinical condition, biochemical analysis, and virological data. The causes of both chronic liver damages and acute insult in all patients were HBV. They were expressing HBV DNA in the sera, positive for IgM anti-HBc, had increased levels of serum bilirubin, compromised prothrombin time; and more than 50% patients had encephalopathy. The standard dose of tenofovir and entecavir was given.
Results: The antiviral effects of tenofovir and entecavir were evident as most patients became negative for HBV DNA in the sera after 90 days of therapy. Also, the levels of serum bilirubin, CTP (Child-Turcotte-Pugh) and MELD (model for end-stage liver disease) score exhibited significant improvement due to antiviral therapy. Although the improvement of liver functions, and liver damages were detected in patients receiving both tenofovir and entecavir, the survival of the patients was significantly higher in those receiving tenofovir compared to entecavir-treated patients.
Conclusion: This prospective study with limited number patients provides a challenge to assess the real potential of tenofovir over entecavir as therapeutic option for ACLF-B by conducting a multicenter clinical trial enrolling patient of different races and background.
Competing Interests: There are no conflicts of interest.
(Copyright: © 2021 Journal of Family Medicine and Primary Care.)
Databáze: MEDLINE
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