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标题:
Presence of precore and core promoter mutants limits the probability of response
[打印本页]
作者:
StephenW
时间:
2012-2-20 22:14
标题:
Presence of precore and core promoter mutants limits the probability of response
This is a strange paper[StephenW]
http://www.ncbi.nlm.nih.gov/pubmed/22307831
Hepatology.
2012 Feb 6. doi: 10.1002/hep.25636. [Epub ahead of print]
Presence of precore and core promoter mutants limits the probability of response to peginterferon in HBeAg-positive chronic hepatitis B.
Sonneveld MJ
,
Rijckborst V
,
Zeuzem S
,
Heathcote EJ
,
Simon K
,
Senturk H
,
Pas SD
,
Hansen BE
,
Janssen HL
.
SourceDepartment of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
AbstractPeginterferon (PEG-IFN) treatment of HBeAg-positive chronic hepatitis B (CHB) results in HBeAg loss in 30% of patients, but clearance of HBV DNA and HBsAg from serum is less often achieved. We investigated whether the presence of precore (PC) and basal core promoter (BCP) mutants before PEG-IFN treatment affects serological and virological response. A total of 214 HBeAg-positive CHB patients treated with PEG-IFN±lamivudine for 52 weeks in a global randomized trial were classified at baseline as wildtype (WT) or non-WT (detectable mutants at PC/BCP) by line-probe assay. Response was assessed at 6 months post-treatment and through long-term follow-up(LTFU). Mutants were detected in 64% of patients, in varying frequencies across HBV genotypes A through D. Patients with WT had higher baseline HBV DNA, HBeAg and HBsAg levels than patients with non-WT. Patients with WT were more likely to achieve HBeAg loss with HBV DNA<10,000 copies/mL (response, 34 versus 11%,p<0.001) and HBsAg clearance (18 versus 2%,p<0.001) at week 78 than non-WT patients. Among WT patients who achieved HBeAg clearance at week 78, 78% had undetectable HBV DNA and 61% achieved HBsAg clearance at LTFU (versus 26% and 15% in non-WT patients,p<0.001 for both). Presence of WT virus at baseline was an independent predictor of response (OR 2.90, 95%CI:1.15-7.31,p=0.023) and HBsAg clearance (OR 5.58, 95%CI:1.26-24.63,p=0.013) and patients with non-A genotypes with detectable mutants had a low probability of response. CONCLUSION: Presence of only WT virus at baseline is a strong predictor of response (HBeAg loss with HBV DNA <10,000 copies/mL) to PEG-IFN for HBeAg-positive CHB. Patients with detectable PC and/or BCP mutants have a lower probability of response and are less optimal candidates for PEG-IFN therapy. (HEPATOLOGY 2012.).
Copyright © 2012 American Association for the Study of Liver Diseases.
作者:
StephenW
时间:
2012-2-20 22:21
这是一个奇怪的论文[StephenW]
肝病。 2012年二月6。 DOI:10.1002/hep.25636。 [出处提前打印]
在HBeAg阳性慢性乙型肝炎前C区和核心启动子突变体的存在限制反应的概率聚乙二醇
sonneveld,Rijckborst至五兆焦耳,Zeuzem希思科特EJ,西蒙ķ,SenturkĤ,PAS SD,汉森,扬森红莲。
源
胃肠病学和肝病,Erasmus MC大学医学中心,鹿特丹,荷兰。
摘要
聚乙二醇(PEG-干扰素)治疗HBeAg阳性慢性乙型肝炎(CHB)的结果在30%的患者在HBeAg的损失,但是从血清HBV DNA和HBsAg清除是不太经常取得。我们调查是否存在前C(PC)和基本核心启动子(BCP)突变体的聚乙二醇干扰素治疗前,会影响血清学和病毒学应答。共有214例HBeAg阳性CHB患者在一个全球性的随机试验,52周PEG-干扰素±拉米夫定治疗基线被列为野生型(WT)或野生型(非检测到突变的PC / BCP)线探针法。在6个月治疗后,并通过长期随访(LTFU)反应评估。 64%的患者,在跨HBV基因型的不同频率突变检测通过D.与WT患者有较高的基线HBV DNA,与非野生型患者HBeAg和HBsAg水平。与野生型的患者更可能比非野生实现与乙型肝炎病毒DNA <10,000拷贝/毫升(反应,34%对11%,P <0.001)和HBsAg清除HBeAg消失,78周(18比2%,P <0.001)患者。在野生型患者78周时达到HBeAg的间隙中,有78%不到的HBV DNA和61%在LTFU取得HBsAg清除(相对于26%和15%,在非野生型的患者,P <0.001)。野生型病毒存在于基线反应的独立预测因素(OR 2.90,95%CI :1.15-7 0.31,P = 0.023)和乙肝表面抗原清除率(OR 5.58,95%CI :1.26-24 0.63,P = 0.013)与患者非A基因型检测突变的概率很低的响应。结论:只有野生型病毒存在于基线是强烈的反应预测HBeAg阳性慢性乙型肝炎(HBeAg消失与HBV DNA <10,000拷贝/毫升)PEG-干扰素。检测PC和/或BCP突变的患者有反应的机率较低,PEG-干扰素治疗不是最佳的选择。 (2012年肝病。)。
版权所有©2012美国肝病研究协会。
作者:
咬牙硬挺
时间:
2012-2-20 22:57
哦?没太看懂…似乎说派罗欣也有不好使的时候
作者:
StephenW
时间:
2012-2-20 23:46
本帖最后由 StephenW 于 2012-2-20 23:46 编辑
回复
咬牙硬挺
的帖子
这篇论文说,如果你是HBeAg阳性的, 有100%的野生型乙肝病毒(没有检测到的前C区/核心启动子突变体病毒),那么你将有一个更好的干扰素治疗回应.
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