Abstract: Objective The aim of this study was to observe the application of entecavir in the treatment of patients with hepatitis B virus carrier and pulmonary tuberculosis during antituberculotic therapy. Methods 164 patients with hepatitis B virus carrier and pulmonary tuberculosis were recruited in our hospital between May 2017 and December 2018, and were randomly divided into observation and control group with 82 cases in each. All the patients were given 4 HREZ/4 ER, and those in the observation group were given entecavir orally for anti-viral therapy. The liver function index, peripheral blood lymphocyte subsets and serum HBV DNA were detected. Results At the end of eight week treatment, serum ALT and AST levels in the observation group were (44.2±1.1)U/L and (38.8±1.3)U/L, significantly lower than 【(81.7±1.5) U/L and (78.2±1.5) U/L, respectively, P＜0.05】 in the control, all serum HBV DNA became negative in the observation group, while they were 【(7.9±0.6)lg copies/mL, P＜0.05】, unchanged in the control; at the end of eight week treatment, the total absorption rate and absorption of tubercular lesions, and sputum smear negative conversion rate in the observation group were 41.5%, 42.7% and 48.8%, significantly higher than 24. 4%, 28.1% and 34.2% , respectively, in the control(P＜0.05); the percentages of peripheral blood CD4⁺ cells,CD8⁺ cells and ratio of CD4⁺/CD8⁺ cells in the observation group were (39.5±3.1)%, (23.9±1.8)% and (1.7±0.2), significantly different as compared to 【(37.1±2.5)%, (26.3±1.3)% and (1.4±0.3), respectively, P<0.05】 in the control group; the incidences of fatigue, right upper-chondrial discomfort, anorexia and drug-induced liver injuries (DILI) in the observation goup were 3.7%, 2.4%, 1.2% and 1.2%, significantly lower than 15.9%, 12.2%, 4.9% and 53.7%, respectively in the control (P<0.05); at the end of three month treatment, the anti-tuberculosis drug resistance rate, discontinuation of some anti-tuberculosis agents because of DILI and totally discontinuation of anti-tuberculosis therapy in the observation were 7.3%. 4.7% and 1.2%, significantly lower than 18.3%, 12.2% and 36.6%, respectively, in the control group(P<0.05). Conclusions The prophylactic application of entecavir in hepatitis B viral carriers complicated with pulmonary tuberculosis during anti-tuberculosis treatment has a good efficacy in inhibiting hepatitis B viral re-activation, which might guarantee the anti-tuberculosis therapy going and immune functions with little side effects and less drug-induced liver injuries.

Key words: Hepatitis B viral carrier, Pulmonary tuberculosis, Entecavir, Anti-tuberculosis therapy, Lymphocyte subsets