Özet:

Purpose: The purpose of treatment in chronic hepatitis B (HBV) infection is to ensure permanent viral suppression, biochemical and histological repair, to prevent long-term complications such as sirosis and/or hepatocellular carcinoma. In current treatment, Tenofovir is disoproxyl, Tenofovir alafenamid and Entekavirpotent drugs. Studies in which real life data for the long-term effectiveness of these drugs are provided are limited. This study was planned to evaluate the backward effectiveness of patients receiving Tenofovir disoproxyl and Entecavir treatment for a long time. Method: In the study, the doses of patients who were diagnosed with KHB between 2007 and 2015 and who did not receive oral antiviral treatment and who received Entekavir (0.5 mg/day) or Tenofovir disoproxyl (245 mg/day) were retrospective. The patient was treated for six months. Those with decompanse syrosis, malignity and other underlying diseases were excluded from assessment. In the evaluation of therapeutic responses; HBV DNA levels, ALT values, seroconversion status were analyzed. Results: 111 patients who were followed in a single center, diagnosed with KHB, who had not previously received antiviral treatment, received two different group treatments, including TDF (n=54, 57% men, average age 44±14 y, 27% HBeAg positive, follow-up period median 38 months) and ETV (n=57, 51% men, average age 46±13 y, 18% HBeAg positive, follow-up period median 48 months). In the TDF group, the initial HBV DNA value (8.0±1,1 copies/mL) was greater and more meaningful than the ETV group (7.7±1,1 copies/mL) (p=0.02). The sixth and 12th treatments are in two groups. When compared HBV DNA negativity in the months, it was found that statistically meaningful HBV DNA negativity was achieved in the ETV group (p<0.05). After the 36th month of treatment, all patients in the TDF group had HBV DNA negative, while 90% of patients in the ETV group had HBV DNA negative. Although the HBV DNA negative rate was not significant in HBeAg positive patients in groups, the HBV DNA negative rate was significantly increased in ETV patients. In the sixth year of treatment, the HBeAg seroconversion rate in the TDF group was higher. In one of the patients in the ETV group (1.7%) HBsAg loss and antiHBs positivization occurred. In the TDF group, there was no HBsAg loss and anti-HBs positivization. The result: in the treatment of KHB, it is shown that similar clinical and laboratory results are taken with long-term use of ETV and TDF drugs. For more accurate results, it is necessary to compare with a lot of patients and prospective clinical trials.

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