新的核类型比旧的核类型更好吗?
Jonggi Choi1, Won-Mook Choi1, Young-Suk Lim1
1Department Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.
Clinics in liver disease
|October 1, 2023
概括
恩特卡维尔,诺福维尔二氧化硫黄和诺福维尔阿拉芬胺在未经治疗的慢性乙型肝炎病毒 (HBV) 患者中显示出极小的抗药性风险. 诺福维尔迪索普罗克西尔烟酸单疗法在预先治疗的患者中有效治疗多药耐药HBV.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 药理学 药理学是指药理学的学科.
背景情况:
- 慢性乙型肝炎病毒 (HBV) 感染仍然是一个重大的全球健康问题.
- 核类型是HBV治疗的主要药物,需要了解它们的耐药性.
- 以前没有接受过治疗的患者需要有效的初始疗法,具有较低的抗性潜力.
研究的目的:
- 为了评估恩特卡维尔 (ETV),诺福维尔二松烟酸 (TDF) 和诺福维尔阿拉芬胺在以前未接受过治疗的慢性HBV患者中的耐药性概况.
- 评估这些药物的病毒学反应率在以前未接受治疗的人群中.
- 为了确定TDF单疗法在重度预治疗的多药耐药HBV的患者中的疗效.
主要方法:
- 随机临床试验的综述,比较ETV,TDF和先前未接受治疗的HBV患者中的tenofoviralafenamide.
- 病毒学反应率的分析,定义为通过聚合酶连锁反应测定无法检测的血清HBVDNA.
- 在一组经过预治疗的患者中评估TDF单一治疗结果,这些患者有证据表明对ETV或阿德福病毒有耐药性.
主要成果:
- 在未接受过治疗的HBV患者中,ETV,TDF和tenofovir alafenamide的耐药性风险很小或不存在.
- 这些核类型在大多数未经治疗的患者中实现了高水平的病毒学反应.
- 在重度预治疗的多药耐药性患者中,TDF单一疗法在实现病毒学反应方面被证明是有效的.
结论:
- 对于以前未接受过治疗的慢性HBV,建议使用ETV,TDF或tenofoviralafenamide进行一线治疗,这是由于耐药性低,疗效高的原因.
- 对于具有复杂耐药性模式的患者,TDF单疗是一种可行的治疗选择,包括对ETV和阿德福维尔耐药的患者.
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