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Influence of Besifovir Dipivoxil Maleate Combined with L-Carnitine on Hepatic Steatosis in Patients with Chronic Hepatitis B

Journal of Korean Medical Science 2020년 35권 17호 p.104 ~ 104
 ( Jung Yeon-Woo ) - Yonsei University College of Medicine Department of Internal Medicine

 ( Kim Moon-Hyun ) - Yonsei University College of Medicine Department of Internal Medicine
김범경 ( Kim Beom-Kyung ) - Yonsei University College of Medicine Department of Internal Medicine
박준용 ( Park Jun-Yong ) - Yonsei University College of Medicine Department of Internal Medicine
김도영 ( Kim Do-Young ) - Yonsei University College of Medicine Department of Internal Medicine
안상훈 ( Ahn Sang-Hoon ) - Yonsei University College of Medicine Department of Internal Medicine
한광협 ( Han Kwang-Hyub ) - Yonsei University College of Medicine Department of Internal Medicine
김승업 ( Kim Seung-Up ) - Yonsei University College of Medicine Department of Internal Medicine

Abstract


Background: Besifovir dipivoxil maleate (BSV) with L-carnitine is the first-line antiviral agent for chronic hepatitis B (CHB) infection. We investigated whether BSV combined with L-carnitine improves hepatic steatosis (HS).

Methods: Treatment-naive patients with CHB who were initiated on antiviral therapy (AVT) were enrolled. The magnitude of HS was assessed using hepatic steatosis index (HSI), and HS improvement was defined as a ≥ 10% reduction in the HSI score from the baseline.

Results: The mean age of the study patients was 56 years with a male predominance (n = 178, 64.7%). The mean body mass index (BMI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and platelet count were 23.5 kg/m2, 49.6 IU/L, 49.0 IU/L, and 191.3 × 109/L, respectively. The mean HSI and fibrosis (FIB)-4 index were 32.6 and 0.5, respectively. After 6 months of AVT, platelet count (mean, 191.3→167.0 × 109/L), fasting glucose (mean, 113.1→105.9 mg/dL), AST (mean, 49.6→28.0 IU/L), ALT (mean, 49.0→33.9 IU/L), and total cholesterol (mean, 170.0→162.1 mg/dL) levels significantly decreased (all P < 0.05). In the BSV group, AST (mean, 95.2→30.2 IU/L) and ALT (mean, 81.1→31.1 IU/L) levels significantly reduced (all P < 0.05), whereas HSI and FIB-4 index were maintained (all P > 0.05). In the univariate analysis, age, BMI, diabetes, cirrhosis, fasting glucose level, and ALT were significantly associated with HS improvement (all P < 0.05).

Conclusion: BSV with L-carnitine did not show any improvement of HS in patients with CHB. Further prospective randomized controlled studies are needed to validate the potential beneficial effects of BSV with L-carnitine in CHB infection.

키워드

L-carnitine; Besifovir; Hepatic Steatosis; Entecavir; Tenofovir
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