拉米和治疗性疫苗的联合使用

zasxz

The Efficacy of Combination Therapy with Lamivudine and Immunization in Patients with Chronic Hepatitis B

Both the hepatitis B virus (HBV) and the immune response of the hosts to HBV play important roles in the pathogenesis of chronic hepatitis B (CHB). Lamivudine (Epivir-HBV) is a potent antiviral agent with minimal immune modulator capacity. Moreover, lamivudine causes severe side effects like breakthrough of HBV DNA and breakthrough hepatitis in patients with CHB.

On the other hand, vaccine therapy, a recently-developed immune therapy, exhibits potent immune modulatory potentials and almost no side effects, but possesses little antiviral capacity in patients with CHB.

The aim of this clinical trial is to evaluate the efficacy of a combination therapy of lamivudine and vaccine in patients with CHB.

Seventy-two patients with CHB (hepatitis B e antigen (HBeAg)-positive, 40; antibody to HBeAg (anti-HBe)-positive, 32). All patients received lamivudine at a dose of 100mg daily for 12 months.

Fifteen patients (HBeAg(+), 9; anti-HBe(+), 6) receiving oral lamivudine were also given a vaccine containing 20mug of hepatitis B surface antigen (HBsAg), intradermally, once every 2 weeks for 12 times (combination therapy).

Results

Twelve months after the start of therapy, serum HBV DNA became negative in 9 of 9 (100%) HBeAg (+) CHB patients receiving combination therapy and in 15 of 31 (48%) HBeAg(+) CHB patients receiving lamivudine monotherapy (P < 0.05).

The rate of seroconversion from HBeAg to anti-HBe was also significantly higher in patients receiving combination therapy (56% versus lamivudine monotherapy, 16%, P < 0.05).

Of the 57 patients receiving lamivudine monotherapy, breakthrough of HBV DNA was found in 10 and breakthrough hepatitis was found in 4; however, these were not seen in any patient receiving combination therapy.

Conclusions

Combination therapy represents a better therapeutic regimen with few complications in patients with CHB, according to the authors.

Third Department of Internal Medicine, Ehime University School of Medicine, Shigenobu-Cho, Ehime 791 0295, Japan.

01/21/05

Reference N Horiike and others. In vivo immunization by vaccine therapy following virus suppression by lamivudine: a novel approach for treating patients with chronic hepatitis B. Journal Clinical Virology 32(2): 156-161. February 2005.

Link to Index to All Hepatitis B Articles - A to Z

candice

我现在就在用这种理念的疗法

yujinone

i'm also using it now!!

特深沉

The Efficacy of Combination Therapy with Lamivudine and Immunization in Patients with Chronic Hepatitis B

拉米夫定和免疫联合疗法对慢性乙肝患者的疗效

Both the hepatitis B virus (HBV) and the immune response of the hosts to HBV play important roles in the pathogenesis of chronic hepatitis B (CHB). Lamivudine (Epivir-HBV) is a potent antiviral agent with minimal immune modulator capacity. Moreover, lamivudine causes severe side effects like breakthrough of HBV DNA and breakthrough hepatitis in patients with CHB.

HBV病毒和宿主的免疫反应，对慢性乙肝的发病都很重要。拉米夫定是有效的抗病毒药物，却很少有免疫调节能力。而且，拉米会导致严重的副作用，例如HBV DNA爆发，或肝病爆发。

On the other hand, vaccine therapy, a recently-developed immune therapy, exhibits potent immune modulatory potentials and almost no side effects, but possesses little antiviral capacity in patients with CHB.

另一方面，疫苗治疗，最新研究的免疫疗法，表现出有效的免疫调节和几乎没有副作用，但很少有抗病毒能力。

The aim of this clinical trial is to evaluate the efficacy of a combination therapy of lamivudine and vaccine in patients with CHB.

该临床试验目的在于评估拉米和疫苗联合疗法的效果。

Seventy-two patients with CHB (hepatitis B e antigen (HBeAg)-positive, 40; antibody to HBeAg (anti-HBe)-positive, 32). All patients received lamivudine at a dose of 100mg daily for 12 months.

72名慢性乙肝患者（e核心抗原HbeAg阳性者40人，核心抗体阳性者32人）。所有患者都接受了拉米夫定100mg/天，持续12个月。

Fifteen patients (HBeAg(+), 9; anti-HBe(+), 6) receiving oral lamivudine were also given a vaccine containing 20mug of hepatitis B surface antigen (HBsAg),

intradermally, once every 2 weeks for 12 times (combination therapy).

15名患者(HBeAg(+), 9; anti-HBe(+), 6) 在口服拉米夫定的同时，还皮下注射了20mug乙肝表面抗原疫苗(HBsAg)，次/2周，共12次。

Results

结果

Twelve months after the start of therapy, serum HBV DNA became negative in 9 of 9 (100%) HBeAg (+) CHB patients receiving combination therapy and in 15 of 31 (48%) HBeAg(+) CHB patients receiving lamivudine monotherapy (P < 0.05).

治疗开始12个月后，接受联合疗法的9名HbeAg阳性患者血清HBV DNA，9人全部转阴（100%）， 单独接受拉米治疗的31人中15人DNA转阴（48%） (P < 0.05)

The rate of seroconversion from HBeAg to anti-HBe was also significantly higher in patients receiving combination therapy (56% versus lamivudine monotherapy, 16%, P < 0.05).

接受联合疗法的患者血清转换（56%e核心抗原转为核心抗体）也明显高于单独使用拉米16% P < 0.05

Of the 57 patients receiving lamivudine monotherapy, breakthrough of HBV DNA was found in 10 and breakthrough hepatitis was found in 4; however, these were not seen in any patient receiving combination therapy.

单独接受拉米治疗的57名患者，HBV DNA爆发的有10人，肝炎发作的有4人；然而，联合疗法的没有发现。

Conclusions

结论

Combination therapy represents a better therapeutic regimen with few complications in patients with CHB, according to the authors.

联合疗法表现出更好的疗效，极少并发症。

Third Department of Internal Medicine, Ehime University School of Medicine,

Shigenobu-Cho, Ehime 791 0295, Japan.

日本Ehime医学院第3科

01/21/05

Reference N Horiike and others. In vivo immunization by vaccine therapy following virus suppression by lamivudine: a novel approach for treating patients with chronic hepatitis B. Journal Clinical Virology 32(2): 156-161. February 2005.

Link to Index to All Hepatitis B Articles - A to Z

特深沉

再说一遍，目前所有治疗性疫苗，获联合疗法，都是在临床试验中，

所有以此名义做治疗的都是骗子。

低科技

Third Department of Internal Medicine, Ehime University School of Medicine,

Shigenobu-Cho, Ehime 791 0295, Japan.

爱媛大学医学部第三内科，日本爱媛县重信町，邮编791-0195

关注

[此贴子已经被作者于2005-7-11 11:22:21编辑过]

啄木鸟307

拉米可以控制乙肝病毒复制这就是人类的一大进步，如果在病毒没发生变异之前唤起自身免疫就有希望，有效的击发免疫药物是个关键。

sadwind

不要寄予太多期望，个例证明，不行。

kitty123

搂主老兄，同志，大哥

咋犯了如此低级的错误呢， 把题目给弄错了，是疫苗跟拉米合用，不是治疗型疫苗跟拉米合用啊，

俺真惊了，快白表了！（青岛话，意思是I服了U,别再犯傻了）