禤中妮,袁淑芳

当前全球慢性乙型肝炎（CHB）感染负担沉重，中国CHB患者群体呈现出老龄化趋势。老年患者常合并基础疾病、存在肾功能储备下降与骨代谢异常问题，传统一线抗病毒药物面临耐药、肾毒性及远期并发症等治疗困难。本文旨在探讨富马酸丙酚替诺福韦（TAF）在老龄化慢性乙型肝炎（CHB）患者中治疗优势，明确其在老龄化慢性乙型肝炎患者治疗中的核心价值，同时展望其应用方向，为临床针对老年人CHB患者制定安全、有效的治疗策略提供参考，助力改善老年人CHB患者的预后与生活质量。

富马酸丙酚替诺福韦（TAF）；富马酸替诺福韦二吡呋酯（TDF）；老龄化；慢性乙型肝炎；安全性

[1] Wu W,Zhu Y,Yu C,Yang S,Ruan B,Chen Y,Li L.Clinical features of treatment-naive patients with hepatitis B virus infection:A community-based survey from high-and intermediate-hepatitis B endemicity regions in Southeast China.Medicine(Baltimore).2017 Apr; 96(16):e6660. [2] 马倩倩.核苷类药物治疗慢性乙型肝炎患者肾功能变化的临床研究[D].南方医科大学,2019. [3] 张煌鑫.乙肝相关肝病患者肝性骨病的横断面研究[D].南昌大学,2024. [4] 刘敏.一线核苷(酸)类似物初治慢性乙型肝炎患者安全性的观察性研究[D].成都医学院,2023. [5] Jeong S,Shin HP,Kim HI.Real-World Single-Center Comparison of the Safety and Efficacy of Entecavir,Tenofovir Disoproxil Fumarate,and Tenofovir Alafenamide in Patients with Chronic Hepatitis B.Intervirology.2022;65(2):94-103. [6] 任天棋,杨倩倩,马鹤铭,等.TAF治疗慢性乙型肝炎的研究进展[J].肝脏,2019,24(11):1319-1322. [7] 朱云竹.富马酸丙酚替诺福韦对慢性乙型肝炎初治及经治患者的疗效及安全性分析[D].安徽医科大学,2022. [8] 玛力帕提·艾尔肯江.富马酸丙酚替诺福韦对乙型肝炎病毒垂直传播的疗效和安全性研究[D].新疆医科大学,2024. [9] Wang H,Wu L.A comparison of the therapeutic efficacy of Tenofovir Disoproxil Fumarate and Entecavir in patients with chronic Hepatitis-B.Pak J Med Sci.2024 Nov;40(10):2390-2394. [10] 张若锦.恩替卡韦经治慢性乙型肝炎患者序贯富马酸丙酚替诺福韦治疗的临床研究[D].汕头大学,2022. [11] Huynh Phuong Nguyen T,Thi Huong Bui Q,Duy Vo T.Clinical Efficacy and Safety of Long-Term Treatment of Tenofovir Alafenamide vs Tenofovir Disoproxil Fumarate for Chronic Hepatitis B in Vietnam.Clin Transl Gastroenterol.2024 Oct 1;15(10):e1. [12] 程家喜,王万党,石梅彬,等.恩替卡韦､富马酸替诺福韦二吡呋酯及富马酸丙酚替诺福韦治疗慢性乙型肝炎的疗效及安全性分析[J].传染病信息,2024,37(01):11-15. [13] Li C,Li H,Gong M,Liu Y,Zhang R,Geng J,Wang H,Yu Z,Wang Z,Liu X,Wei J.A Real-World Study on Safety and Efficacy of TAF Treatment in HBV Patients with High Risk of Osteoporosis or Osteopenia in China.Altern Ther Health Med.2024 Sep;30(9):146-151. PMID:38294749. [14] Chan HLY,Buti M,Lim YS,Agarwal K,Marcellin P,Brunetto M,Chuang WL,Janssen HLA,Fung S,Izumi N,Abdurakhmanov D,Jabłkowski M,Celen MK,Ma X,Caruntu F,Flaherty JF,Abramov F,Wang H,Camus G,Osinusi A,Pan CQ,Shalimar,Seto WK,Gane E;GS-US-320-0110 and GS-US-320-0108 investigators.Long-Term Treatment With Tenofovir Alafenamide for Chronic Hepatitis B Results in High Rates of Viral Suppression and Favorable Renal and Bone Safety.Am J Gastroenterol.2024 Mar 1;119(3):486-496. [15] Wei MT,Le AK,Chang MS,Hsu H,Nguyen P,Zhang JQ,Wong C,Wong C,Cheung R,Nguyen MH.Antiviral therapy and the development of osteopenia/osteoporosis among Asians with chronic hepatitis B.J Med Virol.2019 Jul;91(7):1288-1294. [16] Loosen SH,Killer A,Bock HH,Luedde T,Roderburg C,Kostev K.Association between Chronic Hepatitis B/C and Incidence of Osteoporosis and Bone Fractures:Results from a Retrospective Cohort Study.J Clin Med.2024 Oct 16;13(20):6152. [17] Yip TC,Lai JC,Yam TF,Tse YK,Hui VW,Lai MS,Chan HL,Wong VW,Wong GL.Long-term use of tenofovir disoproxil fumarate increases fracture risk in elderly patients with chronic hepatitis B.J Hepatol.2024 Apr;80(4):553-563. [18] Hou J,Ning Q,Duan Z,Chen Y,Xie Q,Zhang L,Wu S,Tang H,Li J,Lin F,Yang Y,Gong G,Luo Y,Xie S,Wang H,Mateo R,Yazdi T,Abramov F,Yee LJ,Flaherty J,Chen C,Huang Y,Zhang M,Jia J.Five-year Treatment with Tenofovir Alafenamide Achieves High Rates of Viral Suppression,Alanine Aminotransferase Normalization,and Favorable Bone and Renal Safety in Chinese Chronic Hepatitis B Patients.J Clin Transl Hepatol.2024 May 28;12(5):469-480.

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