Tenofovir can down-regulate the portal vein pressure and serum endothelin-1 for patients with hepatitis B-related cirrhosis

LI Jiaxuan; DAI Shixue; XIE Hongmin

doi:10.12122/j.issn.1674-4500.2025.02.12

Abstract：Objective To explore the effects of tenofovir(TAF)on portal hypertension,plasma endothelin-1(ET-1)and the incidence of cirrhosis-derived complications,for patients with hepatitis B-related cirrhosis who had previously been treated with lamivudine(LAM)combined with adefovir dipivoxil(ADV).Methods A total of 100 patients were enrolled into the group of"switching from LAM+ADV to TAF"and were treated with TAF and underwent a follow-up for 24 months in Zhongshan Chen Xinghai Hospital of Integrated Traditional Chinese and Western Medicine from January 2021 to January 2023.The liver function,alpha-fetoprotein(AFP)and viral index,portal vena-related parameters,abdominal ultrasound,renal function,ET-1,and liver cirrhosis-derived complications were observed and compared at the following 5 time points:before enrollment(T1),at the end of the 6th month(T2),at the end of the 12th month(T3),at the end of the 18th month(T4),and at the end of the 24th month(T5),respectively.Results TAF was found to significantly down-regulate the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamyl transpeptides(GGT),total bilirubin(TBIL),hepatitis B surface antigen(HBsAg),and hepatitis B virus DNA(HBV-DNA)in patients with posthepatitis B-related cirrhosis.The levels of serum albumin(ALB)was significantly increased after TAF treatment(P<0.05).There were significant differences in portal vein diameter,portal vein pressure,portal vein thrombosis,fatty liver,and splenomegalgia among the time span from T1 to T5,after TAF treatment(P<0.05).There were no significant differences in blood urea,creatinine or uric acid after TAF treatment when compared with pre-treatment(P>0.05).However,changes of ET-1 from T1 to T5 were significantly different(P=0.012),as well as the incidence of gastrointestinal bleeding(P=0.042).Correlation analysis showed that ET-1 was significantly positively correlated with portal vein diameter,portal vein pressure,portal vein thrombosis,and the incidence of gastrointestinal bleeding(P<0.05).Conclusion Switching from(LAM+ADV)to TAF can significantly down-regulate the levels of ET-1 and improve liver function and thus reduce viral loads in patients with posthepatitis B cirrhosis,and improve portal hypertension and its complications,presenting better indexes in the 24th month than those of 12th month,and TAF did not present significant side effects on renal function.