在接受HBV活性抗逆转录病毒治疗的人群中,B型肝炎病毒复发
Costanza Bertoni1,2, Sara Diotallevi1, Riccardo Lolatto1
1Unit of Infectious Diseases, IRCCS Ospedale San Raffaele, Milan, Italy.
Journal of medical virology
|August 26, 2025
概括
与其他疗法相比,艾滋病毒感染者接受的艾滋病毒抗逆转录病毒治疗 (ART) 风险较低. 较高的ALT水平也与HBV复发有关.
科学领域:
- 肝病学
- 传染性疾病
- 病毒学
背景情况:
- 慢性乙型肝炎病毒 (CHBV) 感染患者需要用双活性抗逆转录病毒疗法 (ART) 进行谨慎的治疗.
- 在ART的PWH/CHBV中,可检测的HBVDNA被定义为HBV反弹.
研究的目的:
- 调查使用特定HBV活性ART治疗方案治疗的PWH/CHBV中与HBV反弹相关的因素.
- 为了比较emtricitabine (FTC) + tenofovir alafenamide (TAF) 与其他ART疗法在预防HBV复发方面的疗效.
主要方法:
- 从2008年10月到2023年8月对PWH/CHBV患者进行的回顾性队列研究.
- 使用多变量逻辑回归来估计HBV反弹的几率,并对CD4细胞,ALT水平和ART活性进行调整.
- 在ART前的初始阳性结果后,基线被定义为第一个阴性HBVDNA;最后的评估是第一个HBV反弹或最后一个无法检测的HBVDNA.
主要成果:
- 在153例PWH/ CHBV中,有25例 (16. 3%) 至少发生一次HBV复发.
- 与3TC/ FTC+特诺福维尔二醇 fumarate (TDF) 相比,使用FTC+TAF的PWH的HBV复发概率显著较低 (aOR=0. 05).
- 与3TC/FTC+TDF相比,单独使用PWH的HBV反弹的概率更高 (aOR=4.88).
- 较高的ALT水平与HBV复发的几率增加有关 (aOR=1. 03每1U/ L).
结论:
- 与单独使用3TC/FTC+TDF和3TC/FTC相比,基于FTC+TAF的ART在控制HBVDNA和预防反弹方面似乎更有效.
- 较高的ALT水平可能表明肝炎增加和HBV复发的风险增加.
- 这些发现表明ART治疗方案的选择对于治疗PWH的CHBV至关重要.
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