我国国产ETV疗效稳定,与进口ETV相比,在疗效与安全性方面无差异，是很多患者首选的抗病毒药物[9][10]。国产ETV疗效确切，但价格昂贵。集采ETV，一月仅需5.5元，显著减轻慢乙肝患者口服药物费用负担。虽然集采药物一般会经过三期临床试验观察后投入使用，但目前没有确切的文献报道集采ETV有效性与安全性。本研究发现：两组患者完全病毒学应答率无统计学差异，但未换药组和换药组中分别有3人（3/104，2.88%）和5人（5/156，3.21%）间歇HBVDNA阳性（均在20IU/ml—2000IU/ml），即为低病毒血症，患HCC风险较高，这可能是由于患者出现耐药，应检测是否耐药并调整NAs治疗，推荐选择新一代抗病毒药物TAF[6][16]。有大量研究表明服用ETV治疗患者换为TAF治疗后可提高或维持完全病毒学应答率[17][18]。由于本研究为回顾性分析，纳入研究时限较短，未追踪患者后续治疗方案及效果；两组患者在不同节点均有ALT波动，无统计学差异，这可能与患者饮食、休息、劳累、饮酒等有关，必要时可行口服保肝药物治疗[6]；HBeAg阴转率及HBeAg/抗-HBe血清学转换率均无明显统计学差异（P值均＞0.05）。
综上所述，集采恩替卡韦为安全抗病毒药物，且价格低廉，可广泛用于临床。本试验的不足之处在于试验周期较短，纳入患者数量较少，应增加病例、延长抗病毒疗程进一步观察集采恩替卡韦的抗病毒疗效与安全性，为临床指导用药提供更充分的证据。
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