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Prevention of liver dysfunction during anti-tuberculosis treatment in chronic hepatitis B virus infected patients complicated with tuberculosis

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Author:
No author available
Journal Title:
Chinese Journal of Clinical Infectious Diseases
Issue:
2
DOI:
10.3760/cma.j.issn.1674-2397.2013.02.008
Key Word:
肝炎病毒,乙型;结核,肺;恩替卡韦;肝损伤;Hepatitis B virus;Tuberculosis,pulmonary;Entecavir;Liver injury

Abstract: Objective To evaluate the preventive effect of entecavir on liver injury in chronic HBV infected patients complicated with tuberculosis receiving anti-tuberculosis treatment.Methods A total of 102 chronic HBV infected patients complicated with tuberculosis were collected from Guangzhou Eighth People' s Hospital and Guangzhou Chest Hospital during January 2011 and May 2012.Patients were divided into three groups:group A (n =33) received entecavir plus anti-tuberculosis treatment,group B (n =29) received lamivudine plus anti-tuberculosis treatment,and group C (n =40) received anti-tuberculosis treatment only.Liver injury,termination of treatment,liver function and HBV DNA load before and after treatment were observed.SPSS 13.0 was used for statistial analysis.Results Two cases (6.1%) in group A,6 cases (20.6%) in group B and 22 cases (55.0%) in group C had liver injury,and the difference among three groups was of statistical difference (x2 =22.126,P < 0.01),but the difference between group A and group B was not significant (x2 =3.024,P>0.05).One case (3.0%) in group A,3 cases (10.3%) in group B and 15 cases (37.5%) in group C terminated the treatment,and the difference among three groups was of statistical significance (x2 =16.008,P < 0.01),but the difference between group A and group B was not significant (x2 =1.410,P >0.05).ALT and AST in group A and group B were not of significant differences before and after anti-tuberculosis treatment,but those in group C were significantly higher (Z =18.306,16.821,P < 0.01).There was no significant difference in HBV DNA load among three groups before the treatment (Z =0.460,P > 0.05),while HBV DNA loads in group A and group B significantly decreased during the treatment,and the difference among three groups after the treatment was significant (Z =23.213,P <0.01).In addition,lower HBV DNA load was observed in group A compared with group B after one month anti-tuberculosis treatment (Z =8.109,P < 0.01).Conclusion Early use of entecavir can effectively prevent liver injury during anti-tuberculosis treatment,ensuring anti-tuberculosis treatment and anti-HBV treatment carried out as planned.

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