Systematic review: lamivudine prophylaxis for chemotherapy-induced reactivatio

liver411

Systematic review: lamivudine prophylaxis for chemotherapy-induced
reactivation of chronic hepatitis B virus infection
Authors: KOHRT, H. E.1; OUYANG, D. L.2; KEEFFE, E. B.3

Source: Alimentary Pharmacology & Therapeutics, Volume 24, Number 7, October
2006, pp. 1003-1016(14)

Publisher: Blackwell Publishing
Abstract:

Summary Background 

Reactivation of hepatitis B virus infection in asymptomatic hepatitis B
surface antigen carriers undergoing chemotherapy or immunosuppressive
therapy is a well-documented and potentially fatal complication. Data
supporting the use of lamivudine for primary prophylaxis have emerged, but
its use remains controversial and is not standardized. Aim 

To review current randomized-controlled trials, randomized trials and
prospective case series to provide a clinically applicable, evidence-based
recommendation. Methods 

The published literature was identified using a MEDLINE/PubMed search with
secondary review of cited publications, and inclusion of all prospective
studies. Results 

In nine prospective trials and one randomized-controlled trial, the rate of
hepatitis among subjects receiving lamivudine prophylaxis ranged from 0% to
20% (16 of 173, 9.2%), compared with 33-67% among controls. Of patients
receiving prophylaxis, 0-24% (15 of 173, 8.7%) developed hepatitis B virus
reactivation, compared with 29-56% of controls. Three reactivation-related
mortalities were reported (one receiving prophylaxis, two controls). No
patients withdrew secondary to toxicity or development of
lamivudine-resistant mutations. Conclusions 

The available data show a four- to sevenfold decrease in the rate of
hepatitis and hepatitis B virus reactivation in patients who receive
lamivudine prophylaxis. It is thus recommended that all hepatitis B surface
antigen carriers receive lamivudine, or a comparable anti-viral agent, as
prophylaxis from the initiation of chemotherapy until at least 1 year
following its completion.
Document Type: Research article

DOI: 10.1111/j.1365-2036.2006.03081.x

Affiliations: 1: Division of Hematology, Department of Medicine, Stanford
University Medical Center, Stanford, CA 2: Department of Medicine, Stanford
University Medical Center, Stanford, CA 3: Division of Gastroenterology and
Hepatology, Department of Medicine, Stanford University Medical Center,
Stanford, CA, USA

八年抗战

Systematic review: lamivudine prophylaxis for chemotherapy-induced
reactivation of chronic hepatitis B virus infection
系统性回顾：拉米夫定对慢性hbv感染的化学疗法催生的反应所产生的预防性
Authors: KOHRT, H. E.1; OUYANG, D. L.2; KEEFFE, E. B.3
作者：
Source: Alimentary Pharmacology & Therapeutics, Volume 24, Number 7, October
2006, pp. 1003-1016(14)
文章来源：
Publisher: Blackwell Publishing
Abstract:

Summary Background 

Reactivation of hepatitis B virus infection in asymptomatic hepatitis B
surface antigen carriers undergoing chemotherapy or immunosuppressive
therapy is a well-documented and potentially fatal complication.
在忍受着化学疗法或者免疫抑制疗法的无症状hbv表面抗原携带者身上的hbv病毒感染的复发
是众所周知的并且潜在的致命的并发症。
Data supporting the use of lamivudine for primary prophylaxis have emerged, but
its use remains controversial and is not standardized. Aim 
能支持将拉米夫定作为主要的预防方式的数据已经出现了，但是数据的用途仍然有争议，没有标准化。

To review current randomized-controlled trials, randomized trials and
prospective case series to provide a clinically applicable, evidence-based
recommendation. Methods 
当前的随机控制试验，随机试验者和prospective的系列实例提供了一个临床可用的，基于证据的建议。(方法)

The published literature was identified using a MEDLINE/PubMed search with
secondary review of cited publications, and inclusion of all prospective
studies. Results 

通过使用MEDLINE/PubMed来检索引用出版物对其的二次介绍和所有prospective的研究结论,出版的文献已经被证实.

In nine prospective trials and one randomized-controlled trial, the rate of
hepatitis among subjects receiving lamivudine prophylaxis ranged from 0% to
20% (16 of 173, 9.2%), compared with 33-67% among controls. Of patients
receiving prophylaxis, 0-24% (15 of 173, 8.7%) developed hepatitis B virus
reactivation, compared with 29-56% of controls. Three reactivation-related
mortalities were reported (one receiving prophylaxis, two controls). No
patients withdrew secondary to toxicity or development of
lamivudine-resistant mutations. Conclusions 
在9个prospective的试验和一个随机控制的试验中,在接受拉米夫定作为预防的人中,肝炎的比例是0%到20%.(16/173,9.2%).
不预防的人是33%-67%.
在接受预防的病人中,0%-24%(15/173,8.7%)发展到hbv复发,而不预防的人是29%-56%.3个复发相关的死亡被报道(
1个接受预防的,两个没有的).没有病人从二期毒性和拉米耐药变异发展的试验中退出

The available data show a four- to sevenfold decrease in the rate of
hepatitis and hepatitis B virus reactivation in patients who receive
lamivudine prophylaxis. It is thus recommended that all hepatitis B surface
antigen carriers receive lamivudine, or a comparable anti-viral agent, as
prophylaxis from the initiation of chemotherapy until at least 1 year
following its completion.
有效的数据显示接受拉米夫定预防的患者肝炎和乙肝复发的比率有4到7倍的减少,因此建议所有hbsag携带者
接受拉米夫定或者类似的抗病毒药剂至少一年的时间作为预防

Document Type: Research article

DOI: 10.1111/j.1365-2036.2006.03081.x

Affiliations: 1: Division of Hematology, Department of Medicine, Stanford
University Medical Center, Stanford, CA 2: Department of Medicine, Stanford
University Medical Center, Stanford, CA 3: Division of Gastroenterology and
Hepatology, Department of Medicine, Stanford University Medical Center,
Stanford, CA, USA

八年抗战

参考

有些词还没有理解:

prospective,

文章的建议是所有携带者均进行抗病毒治疗.

感觉不一定正确

转成25了！

prospective：预期的、预计的

2002落叶

chemotherapy可能有些人不了解,是个很重要的概念:指用化学药物抑制或杀死机内病原微生物,寄生虫及恶性肿瘤细胞,消除缓解由他们所引起的疾病.

希望大家更好的理解这篇文章

[此贴子已经被作者于2007-1-21 15:58:47编辑过]

2002落叶

以下是引用liver411在2006-9-20 4:42:01的发言：

Systematic review: lamivudine prophylaxis for chemotherapy-induced
reactivation of chronic hepatitis B virus infection

系统综述:拉米夫定对化学疗法诱导的慢性HBV感染的再次复发的预防作用.