[English Clinical Trial]尽管严格的停止标准,HBeAg阴,Lam有效性的耐

StephenW

http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2010.06492.x/abstract
在B型肝炎的临床前瞻性研究,e抗原阴性慢性乙型肝炎患者,拉米夫定有效性的耐久性差.

Poor durability of lamivudine effectiveness despite stringent cessation criteria: A prospective clinical study in hepatitis B e antigen-negative chronic hepatitis B patients

• Feng Liu1,2,†,
• Lei Wang1,*,†,
• Xiao Ying Li3,
• You De Liu4,
• Jing Bo Wang3,
• Zhao Hua Zhang3,
• Yao Zong Wang3
  

• Department of Infectious Diseases and Hepatology, the Second Hospital of Shandong University, Shanghai, China
• Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
• Jinan Infectious Disease Hospital, Jinan, China
• Yantai Infectious Disease Hospital, Yantai, China
  

Article first published online: 17 FEB 2011

DOI: 10.1111/j.1440-1746.2010.06492.x

© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd

AbstractBackground and Aims:  Lamivudine, a nucleoside analog, is commonly used for treatment of chronic hepatitis B (CHB) but its durability of effectiveness after withdrawal is still uncertain. This study was designed to assess the durability of lamivudine treatment with stringent cessation criteria in hepatitis B e antigen (HBeAg)-negative patients and to explore potential predictive factors.

Methods:  Sixty one HBeAg-negative CHB patients who had received lamivudine for at least 24 months and had maintained undetectable serum hepatitis B virus (HBV) DNA plus normal alanine aminotransferase for ≥ 18 months before withdrawal were included. They were followed up monthly during the first 4 months and at 3-month or 6-month intervals thereafter. Relapse was defined as serum HBV DNA ≥ 104 copies/mL.

Results:  Thirty one of 61 patients relapsed during follow-up, over 90% occurred within 18 months after lamivudine withdrawal. Cumulative relapse rates at months 6, 12, 24, 36, 48 and 60 were 26.2%, 43.6%, 49.7%, 52.1%, 56.1% and 56.1%, respectively. Cox regression revealed that age was the only predictive factor for relapse, with lower relapse rates found in younger patients. Hepatitis B surface antigen (HBsAg) turned negative in eight patients, and none of them relapsed during follow-up.

Conclusion:  Effectiveness of lamivudine treatment is not durable in HBeAg-negative CHB patients even when stringent cessation criteria are adopted, with the exception of patients aged ≤ 20 years. The ideal end point of lamivudine treatment is clearance of serum HBsAg.

StephenW

谷歌翻译，不是100％准确，仅供参考使用。

摘要

背景和目的：拉米夫定，核苷类似物，通常用于治疗慢性乙型肝炎（CHB），但其耐用性，停药后的成效仍是未知数。这项研究的目的是评估拉米夫定治疗与乙型肝炎e抗原（HBeAg）阴性的患者严格戒烟标准的耐用性和探索潜在的预测因素。

方法：61例HBeAg阴性慢性乙型肝炎患者谁收到至少24个月的拉米夫定，与一直保持前无法检测血清乙型肝炎病毒（HBV）的DNA加正常丙氨酸转氨酶≥18个月内撤出被列入。随后每月的第4个月期间与在此后3个月或6个月的时间间隔。复发定义为血清HBV DNA≥104拷贝/毫升。

结果：3061例，随访期间复发，90％以上发生拉米夫定停药后18个月内。在6个月，12，24，36，48和60的累积复发率分别为26.2％，43.6％，49.7％，52.1％，56.1％和56.1％，分别为。 Cox回归分析显示，年龄是预测复发的唯一因素，降低复发率在年轻患者中发现，。乙型肝炎表面抗原（HBsAg）转负8例，随访期间没有复发。

[Vitamins]结论：即使采用严格的停药准则，拉米在HBeAg-的病人中的（停药后）有效性也不能持续（但年龄小于20岁除外）。拉米的理想停药点是血清HBsAg的清除。

Vitamins

回复 StephenW 的帖子

Conclusions: Effectiveness of lamivudine treatment is not durable in HBeAg-negative CHB patients even when stringent cessation criteria are adopted, with the exception of patients aged ≤ 20 years. The ideal end point of lamivudine treatment is clearance of serum HBsAg.

结论：即使采用严格的停药准则，拉米在HBeAg-的病人中的（停药后）有效性也不能持续（但年龄小于20岁除外）。拉米的理想停药点是血清HBsAg的清除。



在61名病人中有8人HBsAg转阴, 拉米似乎对于某些人很有效。这个对比其他干扰素怎样？是否有研究尝试定位拉米有效人群？

StephenW

回复 Vitamins 的帖子

"在61名病人中有8人HBsAg转阴, 拉米似乎对于某些人很有效。这个对比其他干扰素怎样？是否有研究尝试定位拉米有效人群？"

You ask me a very good question. Since I am not an expert, I can only give you my opinion.
I believe it is our immune system that clears the HBsAg. It can be helped by the use of Interferon or oral anti-viral. But Interferon is the most helpful.

Your English is very good. Please correct any wrong or clumsy Google Translate.

你问我一个很好的问题。因为我不是专家，我只能给你我的意见。
我相信是我们的免疫系统，清除乙肝表面抗原。使用干扰素或口服抗病毒
可以帮助。但干扰素是最有用的。

你的英语是非常好的。请纠正任何错误或笨拙的谷歌翻译。