Entecavir plus adefovir combination treatment for chronic hepatitis B patients a

StephenW

Antivir Ther. 2012;17(1):53-60.
Entecavir plus adefovir combination treatment for chronic hepatitis B patients after failure of nucleoside/nucleotide analogues.Lim YS, Lee TH, Heo NY, Shim JH, Lee HC, Suh DJ.
SourceDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. [email protected].

AbstractBACKGROUND: The combination of entecavir, a nucleoside analogue, and adefovir, a nucleotide analogue, would be a promising salvage treatment for chronic hepatitis B (CHB) patients who fail nucleoside/nucleotide analogue (NA) regimens.
METHODS: A total of 89 CHB patients who had failed NA regimens and were treated with entecavir plus adefovir combination for at least 12 months were included.
RESULTS: Mean baseline HBV DNA of patients was 6.16 ±1.44 log(10) IU/ml. Patients were classed by the number of previously failed NAs; 1 NA (lamivudine; n=15; Group 1), 2 NAs (lamivudine and either adefovir or entecavir; n=39; Group 2) and 3 NAs (lamivudine, adefovir and entecavir; n=35; Group 3). After 12 months of treatment, the mean reduction in HBV DNA was greater in Group 1 than in Group 2 or 3 (-5.81 ±1.71, -3.20 ±1.36 and -2.93 ±1.56 log(10) IU/ml, respectively; P<0.01). The rates of virological response (HBV DNA<2,000 IU/ml) were 100%, 79.5% and 34.3% (P<0.01), and the rates of complete virological response (HBV DNA<60 IU/ml) were 53.3%, 25.6% and 14.3% in Group 1, 2 and 3, respectively (P<0.01) at 12 months. Higher baseline HBV DNA (odds ratio =0.59; P=0.02) and increasing number of previously failed NAs (P<0.01) were independently associated with a lower rate of complete virological response at 12 months.
CONCLUSIONS: Entecavir plus adefovir combination treatment was effective in achieving virological response in CHB patients after failure of NAs. However, its effect progressively decreased as the number of previously failed NAs increased.





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StephenW

Antivir Ther。2012年，17（1）:53- 60。
恩替卡韦加上阿德福韦治疗核苷/核苷酸类似物失败后慢性乙型肝炎患者的结合。
廉生，李TH，许纽约，歼轰沉，李HC，SUH DJ。
来源

消化内科，峨山医学中心，蔚山大学医学院，首尔，韩国。 [email protected]。
摘要
背景：

的一种核苷类似物，恩替卡韦，和阿德福韦，核苷酸类似物，的结合将是一个前途的抢救治疗慢性乙型肝炎（CHB）患者失败核苷/核苷酸类似物（NA）的方案。
方法：

共有89例CHB患者没有NA方案，并与恩替卡韦加上阿德福韦结合治疗至少12个月。
结果：

平均基线HBV DNA为6.16±1.44日志（10）IU / ml的患者。患者归类以前未能来港定居的人数，不适用1拉米夫定（N =15;第1组），NAS（2拉米夫定或者阿德福韦或恩替卡韦; N =39;第2组）和3个NAS（拉米夫定，阿德福韦和恩替卡韦N =35;第3组）。经过12个月的治疗，在第1组的HBV DNA平均减少大于2或3组（-5.81±1.71，-3.20±1.36和-2.93±1.56日志（10）IU / ml，分别，P< 0.01）。病毒学应答率（HBV - DNA<2000 IU / ml的）分别为100％，79.5％和34.3％（P <0.01），和完整的病毒学应答率（HBV - DNA<60 IU / ml的）分别为53.3％，25.6在第1组，2和3，分别在12个月（P <0.01）％和14.3％。基线HBV DNA（比值比= 0.59，P = 0.02）和以前未能来港定居人数增加（P <0.01）独立相关，一个完整的病毒学应答率降低12个月。
结论：

恩替卡韦加上阿德福韦联合治疗，有效地实现定居失败后的慢性乙型肝炎患者的病毒学应答。然而，其效果逐步下降，以前没有定居增加。