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标题: 恩替卡韦长期治疗未使用其他核苷药物的乙肝患者 [打印本页]

作者: StephenW    时间: 2012-8-16 21:25     标题: 恩替卡韦长期治疗未使用其他核苷药物的乙肝患者

本帖最后由 StephenW 于 2012-8-25 12:57 编辑


肝胆速递:恩替卡韦长期治疗4年后,474例患者中,96%未检测到HBV的DNA,0.4%发生恩替卡韦耐药

http://www.journal-of-hepatology.eu/article/S0168-8278%2812%2900404-7/abstract
Long-term continuous entecavir therapy in nucleos(t)ide-naïve chronic hepatitis B patients

    Atsushi Ono    ,
    Fumitaka Suzuki    ,
    Yusuke Kawamura    ,
    Hitomi Sezaki    ,
    Tetsuya Hosaka    ,
    Norio Akuta    ,
    Masahiro Kobayashi    ,
    Yoshiyuki Suzuki    ,
    Satoshi Saitou    ,
    Yasuji Arase    ,
    Kenji Ikeda    ,
    Mariko Kobayashi    ,
    Sachiyo Watahiki    ,
    Rie Mineta    ,
    Hiromitsu Kumada
Department of Hepatology, Toranomon Hospital, Tokyo, Japan

Received 29 September 2011; received in revised form 12 April 2012; accepted 18 April 2012. published online 01 June 2012.


Background & Aims

We determined the antiviral potency and viral resistance rate after 4years of continuous entecavir treatment in patients with chronic hepatitis B (CHB) infection.
Methods

The cumulative rates of undetectable hepatitis B virus DNA (HBV DNA;<2.6 log10 copies/ml), hepatitis B e antigen (HBeAg) seronegativity, seroconversion, alanine aminotransferase (ALT) normalization, and entecavir signature mutations were calculated in 474 nucleos(t)ide-naïve CHB patients (HBeAg-positive: 47%) on continuous entecavir treatment for 4years.
Results

Median age was 47years and follow-up period was 2.4years, with 403, 281, 165, and 73 patients followed-up for at least 1, 2, 3, and 4years, respectively. Incremental increases were observed in the rates of undetectable HBV DNA, HBeAg seroclearance and seroconversion, and ALT normalization, reaching 96%, 42%, 38% and 93%, respectively, by the fourth year. In all, 100% and 93% of patients negative and positive for HBeAg, respectively, had undetectable HBV DNA at year 4. Of 165 patients, HBV DNA was detectable in nine patients after 3years. Multivariate analysis identified HBV DNA level (⩽7.6log10 copies/ml, OR=15.8; 95% CI=43.1–79.9, P=0.001) as an independent predictor of undetectable HBV DNA at year 3. Five patients experienced virological breakthrough including two (0.4%) who developed entecavir-resistance mutations.
Conclusions

Continuous treatment of nucleos(t)ide-naïve CHB patients with entecavir over 4years was associated with 96% chance of undetectable HBV DNA and only 0.4% chance of emerging entecavir-resistant mutations.

作者: StephenW    时间: 2012-8-16 21:26

长期连续恩替卡韦治疗核苷(酸)IDE初治慢性乙肝患者

    淳小野
    文隆铃木,
    悠河村,
    瞳Sezaki
    哲保坂,
    夫Akuta
    正弘小林,
    富野铃木,
    聪斋藤
    安尔荒濑,
    贤治池田
    圆子小林,
    sachiyo Watahiki
    惠峰田
    弘光熊田
部,日本东京虎门​​医院肝病

收到2011年9月29日,在2012年4月12日收到;接受2012年4月18日。 2012年06月01日网上公布。


背景与目的

我们确定了抗病毒效力后4年连续恩替卡韦治疗慢性乙型肝炎(CHB)感染患者和病毒的耐药率。
方法

累积率不到乙肝病毒DNA(HBV  -  DNA <2.6 log10拷贝/毫升),乙型肝炎e抗原(HBeAg)抗体阴性,转阴,谷丙转氨酶(ALT)正常化,和恩替卡韦签名突变被计算在474核苷(T )IDE初治的HBeAg阳性慢性乙型肝炎患者(47%)连续4年恩替卡韦治疗。
结果

年龄中位数为47年和后续期间2.4年,403,281,165,73例患者随访至少1,2,3,4年,。观察增量增加的HBV DNA检测不到率,HBeAg的血清廓清和血清学转换,ALT正常化,达到96%,42%,38%和93%,分别由第四年。在所有中,100%和93%的患者阳性阴性和HBeAg阳性,分别在4年不到的HBV DNA。 165例,HBV DNA的检出9例后3年。多因素分析发现HBV DNA水平(⩽7.6log10拷贝/毫升,OR = 15.8; 95%CI = 43.1-79.9,P = 0.001)在3年不到HBV DNA的独立预测因素。五名病人经历病毒学突破包括开发恩替卡韦耐药突变(0.4%)。
结论

核苷(酸)IDE天真超过4年恩替卡韦的慢性乙型肝炎患者的持续治疗与恩替卡韦耐药突变的新兴只有0.4%的几率不到HBV DNA的96%的机会。
作者: rocgao    时间: 2012-8-17 10:59

恩替还是让人放心的。
作者: 咬牙硬挺    时间: 2012-8-20 08:42

一千个里面有四个恩替耐药的?也不算很少啊。耐药后除了替诺可以补救的药物几乎没有了。所谓一线药物难道是保护最后一线生机的意思?
作者: 肝胆速递    时间: 2012-8-25 00:09

StephenW 发表于 2012-8-16 21:25
http://www.journal-of-hepatology.eu/article/S0168-8278%2812%2900404-7/abstract
Long-term continuous  ...

Long-term continuous entecavir therapy in nucleos(t)ide-naïve chronic hepatitis B patients
恩替卡韦长期治疗未使用其他核苷药物的乙肝患者

肝胆速递:恩替卡韦长期治疗4年后,474例患者中,96%未检测到HBV的DNA,0.4%发生恩替卡韦耐药




作者: lyq2003526    时间: 2012-8-25 20:48

耐药患者可以单独拿出来分析一下,有借鉴作用。




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