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本帖最后由 风雨不动 于 2012-4-14 15:17 编辑
请当心分析这个摘要:
1.需要阅读整份文件
2.样本小
3.样本似乎包括难以治疗的病人
4.病毒突破是没必有对恩替卡韦耐药性,需要阅读整份文件
[我个人的意见, StephenW]
<http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2011.01461.x/abstract>
Long-term efficacy of entecavir therapy in chronic hepatitis B patients
with antiviral resistance to lamivudine and adefovir
M. S. Kwak1, J. W. Choi1, J. S. Lee2, K. A. Kim2, J. H. Suh1, Y. S. Cho1,
S. Y. Won1, B. K. Park1, C. K. Lee1
Article first published online: 13 MAY 2011
DOI: 10.1111/j.1365-2893.2011.01461.x
© 2011 Blackwell Publishing Ltd
Issue
Journal of Viral Hepatitis
Early View (Online Version of Record published before inclusion in an
issue)
Summary. No studies have reported the long-term effects of entecavir
switching in patients with multidrug resistance who developed resistance
after lamivudine/adefovir sequential therapy. We evaluated the efficacy of
96 weeks of entecavir therapy in patients with resistance to
lamivudine/adefovir sequential therapy. In total, 33 patients with chronic
hepatitis B virus (HBV) infection with evidence of active viral replication
(HBV DNA levels ≥105 copies/mL) or a history of treatment failure to
lamivudine/adefovir sequential therapy between April 2007 and July 2009
were treated with entecavir (1.0 mg daily) for at least 48 weeks. The rates
of alanine transaminase (ALT) normalization and HBV DNA negativity were
66.7% (14/21) and 24.2% (8/33) at 48 weeks, respectively. The initial HBV
DNA level was the only factor that was inversely associated with serum HBV
DNA negativity after 48 weeks of entecavir therapy (P < 0.023). At 96
weeks, the rates of ALT normalization and HBV DNA negativity were 77.8%
(7/9) and 16.7% (3/18), respectively. Viral breakthrough occurred in 21.2%
(7/33) and 78.9% (15/19) of patients at 48 and 96 weeks, respectively.
Patients who achieved a HBV DNA level of <4 log10 copies/mL at 48 weeks
maintained a similar HBV DNA level and a normal ALT level until 96 weeks.
Entecavir monotherapy for 96 weeks was not efficacious for patients with
lamivudine/adefovir-resistant HBV. The initial HBV DNA level was the only
predictive factor for antiviral efficacy. However, patients who achieved a
HBV DNA level of <4 log10 copies/mL with a normal ALT level at 48 weeks
should maintain, rather than stop, entecavir therapy.
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