Agustos 2017
Kronik hepatit B tanili hastalarda oral antiviral tedavilerin etkinliginin karsilastirilmasi
Comparison of the efficacy of oral antiviral therapies in chronic hepatitis B patients
- Ana Sayfa
- Sayılar
- Agustos 2017
- Kronik hepatit B tanili hastalarda oral antiviral tedavilerin etkinliginin karsilastirilmasi ...
2 Ayancik Devlet Hastanesi, Dahiliye Klinigi, Sinop
3 Sinop Atatürk Devlet Hastanesi, Acil Servis, Sinop
Özet
Giris ve Amaç: Kronik hepatit B enfeksiyonu dünya çapinda önemli bir saglik sorunudur. Bu enfeksiyon, kronik karaciger hastaligi, siroz ve hepatosellüler karsinoma için etyolojik faktörlerinden biridir. Biz, bu çalismada, 12 ay boyunca antiviral tedavi alan hastalarda antiviral ilaçlarin etkinliklerinin karsilastirilmasini ve tedaviyi etkileyen faktörleri belirlemeyi amaçladik. Gereç ve Yöntem: Çalismaya, gastroenteroloji kliniginde kronik hepatit B tanisi ile takip edilmekte olan 72 hasta dahil edildi. Tenofovir, lamivudin ve entekavir kullanan hastalarin demografik ve laboratuvar verileri hasta kayitlarindan elde edildi. Bulgular: Hastalarin 43’ü (%59,7) erkek (yas ortalamasi 53,6±10,0 yil) iken 29’u (%40,3) kadin (yas ortalamasi 53,6 ±13,3 yil) idi. 35 (%48,6) hastada tenofovir, 19 (%26,4) hastada lamivudin ve 18 (%25) hastada entekavir kullanim öyküsü vardi. Hastalarin 23’ünde (%31,9) HBeAg pozitif ve 49’unda (%68,1) HBeAg negatifti. HBeAg negatif hastalarin 6, 9 ve 12. aylardaki tedaviye yanit oranlari, HBeAg pozitif hasta grubu ile karsilastirildiginda anlamli olarak daha yüksekti (sirasiyla; p=0.001, p=0.015, p=0.001). 5 yillik takipte, hastalarin 30’unun (%45,4) tenofovir, 18’nin (%27,3) lamivudin ve 18’nin (%27,3) entekavir aldigi saptandi. 5 yillik takipte, tenofovir, lamivudin ve entekavir alip HBV-DNA’si tekrardan pozitiflesen hasta sayilari sirasiyla 7/30 (%23,3), 5/18 (%27,7) ve 6/18(%33,3) idi. Sonuç: Kronik hepatit B için tedavi oranlari hala düsüktür. Bu nedenle, yasam boyu tedavi devam etmelidir.
Abstract
Background and Aims: Chronic hepatitis B infection is a serious health problem around the world. This infection is an etiological factor in chronic liver disease, cirrhosis, and hepatocellular carcinoma. In this study, we aimed to compare the efficacy of antiviral drugs and determine the factors affecting treatment in patients receiving antiviral treatment for 12 months. Materials and Methods: Seventy-two patients diagnosed with chronic hepatitis B who were followed up at the gastroenterology clinic were included in the study. Demographic and laboratory data on patients receiving tenofovir, lamivudine, and entecavir were obtained from patient records. Results: Forty-three (59.7%) patients were male (mean age of 53.6±10.0 years), while 29 (40.3%) of them were female (mean age of 53.6±13.3 years). Eighteen (25%) patients had a history of receiving entecavir, 35 (48,6%) had received tenofovir, and 19 (26.4%) had received lamivudine. Twenty-three patients (31.9%) were positive, and 49 patients (68.1%) were negative for HBeAg. Treatment response rates for HBeAg-negative patients at 6, 9, and 12 months were significantly higher than those of the HBeAg-positive patient group (p= 0.001, p= 0.015, p= 0.001, respectively). It was found that 30 patients (45.4%) received tenofovir, 18 (27.3%) received lamivudine, and 18 (27.3%) received entecavir in 5-year follow-up. In 5-year follow-up, the numbers of patients who received tenofovir, lamivudine, and entecavir with HBV-DNA re-positivity were 7/30 (23,3%), 5/18 (27,7%), and 6/18 (33,3%), respectively. Conclusion: The cure rate for chronic hepatitis B remains low. For this reason, lifelong treatment should be continued.
