High Rate of Complete Viral Suppression With Combination Therapy in Patients Wit

StephenW

<http://journals.lww.com/jcge/Abstract/2011/11000/High_Rate_of_Complete_Viral_Suppression_With.15.aspxJournal>
of Clinical Gastroenterology:

November/December 2011 - Volume 45 - Issue 10 - p 900–905

doi: 10.1097/MCG.0b013e318224d64f

LIVER, PANCREAS AND BILIARY TRACT: Original Articles

High Rate of Complete Viral Suppression With Combination Therapy in
Patients With Chronic Hepatitis B and Prior Treatment Failure

Wong, Carrie R. BA*,†; Trinh, Huy N. MD*,‡; Yip, Benjamin BA§; Nguyen,
Huy A. MD‡; Garcia, Ruel T. MD*,‡; Ahmed, Aijaz MD§; Keeffe, Emmet B.
MD§; Nguyen, Mindie H. MD, MAS§

Abstract

Background: Combination therapy for chronic hepatitis B virus (HBV)
infection is recommended for patients with antiviral resistance (AVR) or
partial response (PR) to earlier antiviral therapy; however, data on
outcomes are limited.

Goals: To determine the rate of complete viral suppression (CVS) with
combination therapy and to compare CVS among different indications and
treatment regimens.

Methods: A cohort of 109 consecutive patients with chronic hepatitis B from
3 liver clinics in Northern California was retrospectively studied. All
patients started combination therapy between April 2004 and August 2009 for
the following indications: AVR (n=29), PR (n=60), or others (n=20).
Combination treatments included lamivudine (LAM), adefovir (ADV),
telbivudine (LdT), entecavir (ETV), tenofovir (TDF), and emtricitabine
(FTC). CVS was defined as undetectable serum HBV DNA <100 IU/mL.

Results: Among the patients, who were nearly all Asian (99%), 73% had ≥2
prior treatments and 82% had treatment failure (AVR or PR). Median
treatment duration of combination therapy was 21 months (range, 6 to 50
mo). The majority (77%) achieved CVS after 6 months of various combination
regimens: 80% for ETV+TDF, 76% for TDF+LAM or FTC or LdT, 75% for ETV+ADV,
and 69% for ADV+LAM or LdT (P=0.86). After 6 months of therapy, CVS was
observed in a similar proportion of patients treated for PR and AVR (72%
and 74%, respectively).

Conclusions: Although the majority of 109 treatment-experienced patients
had prior treatment failure, high rates of CVS were rapidly achieved and
did not significantly differ between indications of AVR and PR or between
ETV-based and TDF-based regimens.



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StephenW

[谷歌翻译是不是100％正确，仅供参考，使用。]

临床消化病：

11月/ 2011年12月 - 45卷 - 第10期 - P 900-905

DOI：10.1097/MCG.0b013e318224d64f

肝脏，胰腺和胆道：原创文章

完成联合治疗的病毒抑制率高
慢性乙型肝炎治疗前心力衰竭患者

黄，嘉莉R. BA *，†;郑氏，伊北路MD *‡;业，本杰明BA §;阮，
伊答：MD‡;加西亚，Ruel T. MD *‡;艾哈迈德，Aijaz医师§; Keeffe，埃米特B.
医师§;阮，Mindie H.医师，MAS §

摘要

背景：联合治疗慢性乙型肝炎病毒（HBV）
感染病毒抗药性的患者（AVR）的建议或
部分缓解（PR）较早的抗病毒药物治疗，但数据
结果是有限的。

目标：要确定完整的病毒抑制率（CVS）
联合治疗和比较不同适应症CVS
治疗方案。

方法：109例慢性乙型肝炎患者的队列
在北加州的肝诊所进行回顾性研究。所有
患者2004年4月至2009年8月开始联合治疗
以下适应症：AVR（N = 29），PR（N = 60），或其他组（n = 20）。
联合治疗包括拉米夫定（LAM），阿德福韦（ADV），
替比夫定（LDT），恩替卡韦（ETV），替诺福韦（TDF），和恩曲他滨
（FTC）。 CVS被定义为检测不到血清HBV DNA <100国际单位/毫升。

结果：在患者，几乎所有的亚洲（99％），73％≥2
前治疗和82％，治疗失败（AVR或公关）。中位数
综合疗法治疗时间为21个月（6〜50范围内，
MO）。大多数（77％）取得CVS各种组合后6个月
方案：80％用于教育电视+ TDF，TDF +林或联邦贸易委员会或LDT的76％，75％用于教育电视+ ADV，
ADV + LAM或LDT（P = 0.86）和69％。 6个月的治疗后，CVS
观察到类似的公关和AVR治疗的患者比例（72％
和74％，分别）。

结论：尽管大多数109例治疗经验的患者
前治疗失败率很高，CVS的迅速实现，
没有显著差异AVR和PR之间的适应症或者
教育电视和TDF基于方案。