Over years or decades, chronic hepatitis B virus (HBV) infection can progress
to advanced liver disease including cirrhosis (scarring) and hepatocellular
carcinoma. Compensated cirrhosis means the liver is heavily damaged but can
still carry out its normal functions; decompensated cirrhosis occurs when the
liver fails to perform properly.
Several antiviral agents are used to treat chronic hepatitis B, but therapy
can be risky in patients with decompensated cirrhosis. However, this group
also stands to benefit most from effective treatment.
Ju Hyun Shim from the University of Ulsan College of Medicine in Seoul and
colleagues evaluated entecavir as first-line monotherapy in a group of 70
Korean hepatitis B patients with decompensated cirrhosis who started treatment
with 0.5 g/day entecavir between January 2007 and March 2008.
None of the patients had received prior therapy using other antiviral agent or
interferon. Participants had HBV DNA viral load levels of at least 4 log
copies/mL at baseline. None had evidence of hepatocellular carcinoma the time
of treatment initiation and none had undergone prior liver transplantation;
individuals with HIV or hepatitis C coinfection were excluded.
Liver cirrhosis was diagnosed based on clinical, radiological, or histological
(biopsy) assessments. Decompensated disease was defined as a
Child-Turcotte-Pugh (CTP) score of 7 or higher (class B and C) or the presence
of portal hypertension complications such as ascites (abdominal fluid
accumulation), bleeding varices, or hepatic encephalopathy (brain impairment).
The investigators looked at clinical outcomes among all 70 decompensated
patients using an intent-to-treat analysis. They also compared responses in 55
decompensated patients who received entecavir for at least 12 months and 144
patients with compensated liver disease. In both groups, about one-third were
women and approximately half were hepatitis B "e" antigen (HBeAg) positive,
but the decompensated patients were slightly older on average (53 vs 47 years).
The decompensated and compensated groups were evaluated every 3-6 months with
tests for liver function, prothrombin time (a measure of blood clotting),
HBeAg, HBe antibodies, and HBV DNA levels.
----------------------------------------------------------
过去几年或几十年，慢性乙型肝炎病毒（乙型肝炎病毒）感染进展 先进的肝脏疾病包括肝硬化（疤痕），肝癌 癌。肝硬化补偿是指肝脏严重受损，但可以 仍然履行其正常功能；失代偿期肝硬化发生时 肝脏未能正确执行。 一些抗病毒药物用于治疗慢性乙型肝炎的治疗，但 可以是危险的患者失代偿性肝硬化。然而，这组 同样受益最有效的治疗。 据玄垫片从蔚山大学医学院在汉城 同事评价恩替卡韦作为一线治疗的一组70 韩国乙型肝炎失代偿期肝硬化患者谁开始治疗 0.5克/天的恩替卡韦在一月2007日和3月2008。 病人没有收到事先治疗使用其他抗病毒药物或 干扰素。与会者有乙肝病毒脱氧核糖核酸病毒载量水平至少4日志 拷贝/毫升在基线。没有任何证据表明肝癌时间 开始治疗前，没有经历肝移植； 个人与艾滋病毒或丙型肝炎感染被排除。 肝硬化是临床诊断的基础上，影像学，组织学 （活检）评估。失代偿性疾病的定义是 儿童特科特（CT）评分的7或更高（乙级和丙级）或存在 门静脉高压症的并发症，如腹水（腹部流体 积累），静脉曲张出血，或肝性脑病（脑损害）。 调查人员在临床结果之间的所有70个失代偿 患者使用意向治疗分析。他们还比较反应55 失代偿患者谁收到恩替卡韦治疗至少12个月和144 补偿患者的肝脏疾病。在这两个群体，大约有三分之一是 妇女大约有一半是乙肝“抗原（抗原）阳性， 但在失代偿患者略的平均年龄（53-47年）。 在失代偿补偿评估组每3 - 6个月 肝功能检测，凝血酶原时间（衡量血凝块）， 大三阳，乙肝e抗体，乙型肝炎病毒脱氧核糖核酸水平。
| 
发表于 2011-8-20 17:17
