HBV DNA suppression and HBsAg clearance in HBeAg negative chronic hepatitis B pa

StephenW

http://www.docguide.com/hbv-dna-suppression-and-hbsag-clearance-hbeag-negative-chronic-hepatitis-b-patients-lamivudine-thera?hash=c8431e6c&eid=25104&alrhash=2f4244-e14fac0ff7ef1d5b0c78458126191858

Source: J Hepatol  |  Posted 5 days agoHBV DNA suppression and HBsAg clearance in HBeAg negative chronic hepatitis B patients on lamivudine therapy for over 5 years; Fasano M, Lampertico P, Marzano A, Di Marco V, Niro GA, Brancaccio G, Marengo A, Scotto G, Brunetto MR, Gaeta GB, Rizzetto M, Angarano G, Santantonio T; Journal of Hepatology (Feb 2012)

BACKGROUND&AIMS: In long-term responder patients, it is unclear if lamivudine (LAM) monotherapy should be continued or switched to a high-genetic-barrier analogue. This study aims at assessing LAM efficacy over a 5-year period and the residual risk of drug resistance. The rate of HBsAg clearance and LAM long-term safety profile were also evaluated. METHODS: 191 patients with chronic HBeAg-negative hepatitis B successfully treated with LAM monotherapy for at least 5 years were included. Biochemical and virological tests were assessed every 3 months in all patients and HBsAg quantification was performed in 45/191. Reverse-transcriptase (RT) region was directly sequenced in virological breakthrough patients. RESULTS: 191 patients (148 males, median age 53 years, 72 with compensated cirrhosis) responding to 60-month-LAM monotherapy continued receiving LAM monotherapy beyond the initial 5 years and were followed for an additional 36-month median period (range 1-108). Virological response was maintained in 128/191 patients (67%) and HBsAg clearance was observed in 15/128 (11.7%) after a 32-month median period (range 1-65). The 63 remaining patients (33%) showed virological breakthrough after a 15-month median treatment (range 1-78). RT region analysis was performed in 38/63 breakthrough patients and LAM resistant mutations were found in 37/38. No significant side effects were observed.
CONCLUSIONS: In long-term responder patients, continuation of LAM monotherapy resulted in persistent viral suppression in most cases with undetectable HBV DNA by real-time PCR; moreover, 11.7% of these patients cleared HBsAg. Selection of LAM resistance, however, can still occur even after successful long-term therapy, thus emphasizing the importance of a careful virological monitoring.

StephenW

来源：J肝胆病杂志|发表于5天前
HBV DNA抑制和拉米夫定治疗5年以上在HBeAg阴性慢性乙型肝炎患者HBsAg清除;法萨诺男，磷，马扎诺一邸马可波罗至五，德尼罗遗传，BrancaccioĞ，马伦哥一个，ScottoĞ，Brunetto议员，加埃塔Lampertico GB，Rizzetto中号，AngaranoĞ，Santantonioţ肝病学杂志（2012年二月）
  
背景与目的：在长期的应答患者，目前还不清楚如果应继续拉米夫定（LAM）单一或切换到高基因屏障的模拟。本研究旨在评估5​​年期间，林疗效和耐药性的残余风险。率HBsAg清除和林的长期安全性进行了评价。方法：191例HBeAg阴性慢性肝炎乙成功林单药治疗至少5年被列入。生化和病毒学测试，评估每3个月，所有患者和乙肝表面抗原定量在45/191。逆转录（RT）区直接测序在病毒学突破的患者。结果：191例患者（148名男性，平均年龄53岁，代偿性肝硬化72）60个月的林单一超出了最初的5年里继续接收单一林和额外的36个月的中位数期间（1  - 108）。病毒学应答维持在128/191例（67％）和HBsAg清除后32个月的中位数期间（1-65）15/128（11.7％）。经过15个月的平均治疗（1-78），63（33％），其余患者表现病毒学突破。 RT区进行分析，在突破38/63例，并在37/38发现林的耐药性突变。没有明显的副作用进行观察。
结论：在长期应答患者，导致拉米单一的延续在大多数情况下，持续抑制病毒实时PCR检测不到HBV DNA的;此外，11.7％的患者清除乙肝表面抗原。拉米耐的选择，但是，仍然可以发生，甚至成功后长期治疗，从而强调了仔细的病毒学监测的重要性。

sunpk861007

看来抗病毒对表面抗原的清除还是有效的！

疯一点好

应该是个好消息，但就是有些单词不知什么意思。

咬牙硬挺

是好消息吗

StephenW

回复 咬牙硬挺 的帖子

不是.
那些仍在使用拉米夫定5年或更多和仍然做好的人，应该有更频繁的检查。

咬牙硬挺

这个帖子应该转到乙肝交流板块，很多人拉米夫定五年以上了