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Abstract：
To explore the therapeutic effectiveness of tenofovir alafenamide (TAF) and tenofovir disoproxil fumarate (TDF) on the treatment for chronic hepatitis B (CHB). Retrospectively analyzing 241 cases of chronic hepatitis B patients admitted to our hospital from January 2020 to December 2021, they were divided into a TAF group of 180 cases and a TDF group of 61 cases. The liver function, serum virus markers, clinical efficacy, adverse reactions and cost-effectiveness ratio (CER) analysis of 2 groups were compared. Two groups of patients had no statistically significant difference in the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) before treatment. After treatment, the levels of ALT, AST and TBIL were lower than before treatment in both groups (P < .05), but the inter-group difference was not statistically significant (P > .05). After treatment, Hepatitis B surface antigen (HBsAg) conversion rate and Hepatitis B virus DNA (HBV-DNA) conversion rate in the 2 groups had no statistically significant difference. After treatment, the difference in total clinical cure rate between the 2 groups has no statistical significance (P > .05), adverse reactions rate of TAF group was lower than that of TDF group (P < .05). The drug cost median of TAF group was higher than that of TDF (P < .05), but Cost-effectiveness analysis showed the CER of TAF group was similar of TDF group. TAF or TDF therapy can both improve liver function and promote recovery in patients with CHB, achieving the goal of treatment. TAF have more cost but have similar CER to TDF. Moreover, TAF therapy has a higher safety profile.
摘要：
探讨替诺福韦艾拉酚胺(TAF)和富马酸替诺福韦酯(TDF)治疗慢性乙型肝炎(CHB)的疗效。回顾性分析我院2020年1月至2021年12月收治的241例慢性乙型肝炎患者，分为TAF组180例和TDF组61例。肝功能,血清病毒标记，临床疗效,比较2组患者的不良反应及成本-效果比(CER)分析。两组患者的谷丙转氨酶(ALT)水平差异无统计学意义,治疗前天门冬氨酸转氨酶(AST)和总胆红素(TBIL)。治疗后,ALT的水平，与治疗前比较，两组患者的AST和TBIL均降低（P<0.05）。但组间差异无统计学意义(P>.05)。治疗后,乙型肝炎表面抗原(HBsAg)转化率和乙型肝炎病毒DNA(HBV-DNA)转化率在2组比较差异无统计学意义。治疗后,两组临床总治愈率差异无统计学意义(P>.05),TAF组不良反应发生率低于TDF组（P<0.05）。TAF组的药物成本中位数高于TDF组（P<0.05），但成本-效果分析显示TAF组的CER与TDF组相似。TAF或TDF治疗既可以改善肝功能，促进CHB患者的恢复，达到治疗的目标。TAF有更多的成本，但有类似的CERTDF。此外，TAF疗法具有更高的安全性。
