Clinical efficacy and safety of glutathione combined with TDF in the treatment of hepatocellular carcinoma patients with HBV infection after TACE

Huang Yunxia; Yang Haiyan; Huang Xuexia; Fan Wenjun; Zhou Jianhua; Luo Fei

doi:10.3969/j.issn.1671-6450.2025.02.004

Abstract：Objective To explore the effectiveness and safety of using glutathione in conjunction with tenofovir disoproxil fumarate(TDF)for patients with hepatocellular carcinoma(HCC)who also have hepatitis B virus(HBV)infection,following interventional therapy.Methods Eighty-eight patients diagnosed with hepatocellular carcinoma(HCC)and hepa-titis B virus(HBV)infection were selected from the patient population of hepatobiliary surgery of the Affiliated Hospital of North Sichuan Medical College between March 2022 and March 2024.These patients were randomly assigned to either the observation group(n=44)or the control group(n=44).All participants underwent trancatheter arterial chemoembolization as part of their treatment.The control group received standard continuous antiviral therapy with Tenofovir Disoproxil Fuma-rate(TDF),while the observation group received additional treatment with reduced glutathione in conjunction with the standard therapy.Various clinical parameters,including liver function tests[such as total bilirubin(TBil),alanine aminotrans-ferase(ALT),and aspartate aminotransferase(AST)],coagulation function tests[including prothrombin activity(PTA),pro-thrombin time(PT),and activated partial thromboplastin time(APTT)],as well as nutrition-related indicators[albumin(Alb),globulin(Glb),and total protein(TP)],were evaluated in both groups before and after the treatment.Additionally,the inci-dence of adverse events during hospitalization and within one month after discharge was compared between the two groups.Results There was no significant discrepancy in the overall clinical response rate observed between the two groups(x2/P=0.138/0.711).Post-treatment,it was noted that the serum levels of TBil,ALT,and AST in the observation group registered a decrease in comparison to the values documented in the control group(t/P=3.258/0.002,6.960/＜0.001,5.828/＜0.001).The PTA recorded in the observation group outperformed that of the control group,with PT and APTT val-ues being lower in the former(t/P=6.434/＜0.001,5.652/＜0.001,5 331/＜0.001).No significant variance was found in Glb lev-els post-treatment between the two groups(P＞0.05);however,the levels of Alb and TP in the observation group demon-strated an increase over those in the control group(t/P=5319/＜0.001,5.586/＜0.001).The total incidence of adverse reac-tions throughout hospitalization and within 1 month after discharge showed no statistically significant difference between the two groups(x2/P=0.386/0.534).Conclusion Administering TDF antiviral treatment in combination with reduced gluta-thione to patients with HCC and HBV infection has been shown to decrease liver function impairment following intervention-al therapy,enhance coagulation function,and boost nutritional status.The prompt utilization of reduced glutathione holds a promising clinical outlook for HBV-infected individuals post interventional therapy for liver cancer.