一个关于肝移植的临床研究摘要

drunk_hutu

供参考，贴出原文，然后我把大意译出来。
VIENNA, AUSTRIA -- April 27, 2006 -- The combination of adefovir dipivoxil (ADV, HepseraR) and lamivudine started before liver transplantation and continued afterwards safely prevents graft re-infection in patients with lamivudine-resistant chronic hepatitis B either with or without concurrent hepatitis B immune globulin therapy, researchers reported at the 41st Annual Meeting of the European Association for the Study of the Liver (EASL).
ADV is the first nucleotide analogue available for the treatment of chronic hepatitis B.
对于拉米抗药的患者，在肝移植前后联合用阿德福韦和拉米夫定能有效阻止再感染，无论其是否使用了乙肝免疫球蛋白治疗。

Eugene Schiff, MD, professor of medicine and chief, hepatology division, University of Miami School of Medicine in Miami, Florida, United States, presented the results of a long-term follow-up in 57 patients who were treated with ADV 10 mg/day added to ongoing lamivudine 100 mg/day both before and after liver transplantation.All subjects were enrolled in Study 435, which tested the safety and efficacy of ADV for the treatment of wait-listed and post-transplantation patients with lamivudine-resistant chronic hepatitis B.
迈阿密大学的这项研究是基于57个在移植前后服用每天10微克阿德加上100微克拉米的病人。


"Our findings are extremely important because re-infection not only reduces graft survival but also accelerates disease progression and has been associated with death in the first 12 months after transplantation," Dr. Schiff said on April 26th.

这项发现很重要，因为再感染不仅降低了移植的成功率并会加重病情从而导致移植后12个月内的死亡率上升。
Thirty four patients in the present analysis also received hepatitis B immune globulin.
34个病人（60%）同时使用了免疫球蛋白
Results show that over 80% of patients never had detectable hepatitis B virus DNA at a mean post-transplantation follow-up of 36 weeks, and 93% never had detectable hepatitis B surface antigen (HBsAg).
结果显示，在移植后平均36周后，超过80%的病人DNA阴性，93％的人澳抗阴性。
ADV treatment was safe and generally well tolerated. Four (7%) patients stopped ADV because of an adverse event, however, none was judged to be due to ADV treatment.
阿德是安全的且不易耐药。期间有7％的病人停止用阿德，但都不是阿德本身导致的。
No patient who underwent on-study liver transplantation developed resistance over a mean of 67 weeks of ADV treatment. The cumulative probabilities of resistance were 0% at 48 weeks, 2% at 96 weeks, and 2% at 144 weeks.
平均67周内没有发现抗药性。96周甚至144周的抗药性只是2%，
"The take-home message is that most patients who received ADV plus lamivudine both before and after liver transplantation showed no evidence of re-infection with the hepatitis B virus, whether or not they were taking concurrent hepatitis B immunoglobulin," Dr. Schiff said.
最重要的信息是病人没有再感染，无论他们是否接受免疫球蛋白。
The pre- and post-transplantation treatment of chronic hepatitis B has been a major clinical challenge, he added. Interferon-based treatments prior to transplantation have been associated with serious adverse effects in patients with decompensated cirrhosis and are contraindicated after transplant because they increase the risk of graft injection.
肝移植前后的处理向来是挑战。对于失代偿的硬化患者，移植前干扰素治疗被认为有严重副作用，并且移植后再感染概率高。
Hepatitis B immune globulins, which are frequently used with antivirals as prophylaxis against recurrent hepatitis B virus in post-transplant patients, require parenteral administration and are too expensive for widespread use, he explained.

Genotypic hepatitis B virus lamivudine resistance can be found in up to 70% of hepatitis B virus-infected individuals treated with lamivudine for up to 4 years, Dr. Schiff said. These patients can develop a lamivudine-resistant hepatitis B virus strain that is potentially transmissible to hepatitis B virus-vaccinated individuals.

More than 400 million people are chronic hepatitis B carriers worldwide. Approximately 1.25 million people are affected in the U.S.

The study was supported by Gilead Sciences in Foster City, California.


[Presentation title: Safety and Efficacy of Adefovir Dipivoxil in Patients with Lamivudine-Resistant Chronic Hepatitis B Undergoing Liver Transplantation. Abstract 2　

总计一点，老美写东西就是罗嗦，用中国话一说也就几句有用。
不过，这也是人家避免学术纷争的一种方法，说多点漏洞就少。

不死鸟

好贴。