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标题: [英文研究]HBeAg阴性患者:阿德福韦酯与聚乙二醇干扰素α- 2a [打印本页]

作者: StephenW    时间: 2011-7-20 12:12     标题: [英文研究]HBeAg阴性患者:阿德福韦酯与聚乙二醇干扰素α- 2a

本帖最后由 StephenW 于 2011-7-20 12:12 编辑

<http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2010.01332.x/abstract>

HBeAg阴性患者:阿德福韦酯与聚乙二醇干扰素α- 2a序贯疗法


Sequential therapy with adefovir dipivoxil and pegylated Interferon Alfa-2a
for HBeAg-negative patients

R. Moucari1,2,3, N. Boyer1,2,3, M.-P. Ripault1,2,3, C. Castelnau1,2,3, V.
Mackiewicz4, A. Dauvergne5, D. Valla1,2,3, M. Vidaud5, M.-H. N. Chanoine4,
P. Marcellin1,2,3

Article first published online: 17 MAY 2010

DOI: 10.1111/j.1365-2893.2010.01332.x

© 2010 Blackwell Publishing Ltd
Issue

Financial Support: None Potential Conflict of Interest: P. Marcellin
advises, is a consultant for, and is on the speakers’ bureau of Roche,
Schering-Plough, Gilead, Bristol-Myers Squibb, GlaxoSmithKline, and
Idenix-Novartis. He is a consultant for and advises Vertex, Valeant, Human
Genome Sciences, Cythesis, Intermune, Wyeth, and Tibotec.

Journal of Viral Hepatitis
Volume 18, Issue 8, pages 580–586, August 2011

Summary.  To assess the impact of sequential therapy with adefovir
dipivoxil (ADV) and pegylated interferon alfa-2a (PEG-IFN) on virological
(serum HBV-DNA) and serological (serum HBsAg) response in 20 consecutive
HBeAg-negative patients. Patients received ADV for 20 weeks, then ADV and
PEG-IFN for 4 weeks and lastly PEG-IFN for 44 weeks. Serum HBV-DNA and
HBsAg were assessed at baseline, during therapy (weeks 20, 44 and 68) and
follow-up (weeks 92 and 116). Sustained virological response (SVR) was
defined as serum HBV-DNA <10 000 copies/mL (partial) or <70 copies/mL
(complete) 24 weeks after stopping treatment. A serological response was
defined as a serum HBsAg decrease ≥1 log10IU/mL at the end of treatment.
Baseline median serum HBV-DNA and HBsAg levels were 7.6 log10copies/mL and
3.8 log10IU/mL, respectively. Ten patients (50%) achieved SVR, six of them
had partial response and four complete response. Four patients (20%)
achieved serological response. Complete SVRs showed a major and steep
decline in HBsAg level with a median decrease of 0.5, 1.6 and 2.0
log10IU/mL at treatment week 20, 44 and 68, respectively. Partial SVRs
showed a slight and slow decline in serum HBsAg level (0.1, 0.4, and 0.6
log IU/mL at weeks 20, 44 and 68, respectively). On-treatment serum HBsAg
decrease had a high accuracy to predict SVR (AUROC = 0.88). Our results
suggest that sequential therapy might be an interesting strategy for
HBeAg-negative patients. Serum HBsAg kinetics seem to be an accurate tool
to predict SVR. Large clinical trials are needed to explore this strategy
with more potent analogues.
作者: StephenW    时间: 2011-7-20 12:15

谷歌翻译
不是100%准确,仅供参考使用.


财政支持:无潜在的利益冲突:P Marcellin
建议,是一个顾问,对发言者的罗氏局,
先灵葆雅,Gilead公司,施贵宝,葛兰素史克,和
Idenix公司,诺华公司。他是一名顾问,并建议顶点,非专利,人力
基因组科学,Cythesis,InterMune公司,惠氏,和Tibotec公司。

中国病毒性肝炎
第18卷,第8期,第580-586页,2011年8月

为了评估序贯疗法阿德福韦的影响摘要。
酯(ADV)和聚乙二醇干扰素α- 2a(PEG -干扰素)病毒学
(血清HBV - DNA)和血清学反应(血清HBsAg)连续20个
HBeAg阴性患者。患者接受20周ADV,然后adv和
PEG -干扰素4周,最后PEG -干扰素44个星期。血清HBV - DNA和
乙肝表面抗原在基线进行评估,在治疗过程中(20,44和68周)和
后续(92周和116周)。持续病毒学应答(SVR)
定义为血清HBV - DNA <10 000拷贝/毫升(部分)或<70拷贝/ ml
(完成)24周后停止治疗。血清学反应
定义为血清HBsAg下降≥1 log10IU/mL在治疗结束。
基线中位数血清HBV - DNA和HBsAg水平分别为7.6 log10copies/mL和
3.8 log10IU/mL,分别。 10例患者(50%)达到SVR,其中6
局部反应和四个完整的响应。四名病人(20%)
实现了血清学反应。完成SVRS表明一项重大而陡
HBsAg水平下降了0.5,1.6和2.0的中位数下降
log10IU/mL在治疗20周,分别为44和68。部分SVRS
显示在血清HBsAg水平的轻微和缓慢下降(0.1,0.4和0.6
日志IU / ml,分别在20,44和68周)。治疗血清HBsAg
减少了一个高精度的预测SVR(AUROC = 0.88)。我们的研究结果
建议序贯疗法可能是一个有趣的策略
HBeAg阴性患者。血清HBsAg动力学似乎是一个准确的工具
预测SVR的。需要大规模的临床试验,以探索这一战略
更有力的类似物。
作者: lin12345    时间: 2011-7-20 13:41

好东西@!
作者: kennyu    时间: 2011-7-21 13:05

StephenW 发表于 2011-7-20 12:12
HBeAg阴性患者:阿德福韦酯与聚乙二醇干扰素α- 2a序贯疗法

这个结果不错啊,希望能够有更多的序贯疗法的实验结果出来。
从临床表现看,经过长期的核苷抗病毒治疗之后,如果能够保持较好的病毒抑制,
是否都应该考虑使用干扰素进行抗病毒治疗呢?

作者: StephenW    时间: 2011-7-21 13:34

kennyu 发表于 2011-7-21 13:05
这个结果不错啊,希望能够有更多的序贯疗法的实验结果出来。
从临床表现看,经过长期的核苷抗病毒治疗之 ...

"是否都应该考虑使用干扰素进行抗病毒治疗呢?" - 不适合每个人(如
失代偿肝硬化)。但年轻患者,都应该考虑.
作者: kennyu    时间: 2011-7-22 00:43

StephenW 发表于 2011-7-21 13:34
"是否都应该考虑使用干扰素进行抗病毒治疗呢?" - 不适合每个人(如
失代偿肝硬化)。但年轻患者,都应该 ...

同意。干扰素的确有较多的禁忌啊。另,二吐为慢为何不在继续发表他的治疗记录了?

他的治疗方案比较有意思,我一直想知道结果。





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