High efficacy of adefovir and entecavir combination therapy in patients with nuc

StephenW

Korean J Hepatol. 2012 Mar;18(1):75-83. Epub 2012 Mar 22.

High efficacy of adefovir and entecavir combination therapy in patients with nucleoside-refractory hepatitis B.

Source: http://www.ncbi.nlm.nih.gov/pubmed/22511906

Source: Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.

Abstract

BACKGROUND/AIMS:

Newly developed and potent antiviral agents suffer from the problem of drug resistance. Multidrug resistance is a major impediment in the treatment of patients with chronic hepatitis B (CHB). In line with American Association for the Study of Liver Diseases guidelines, adefovir dipivoxil (ADV) add-on therapy is recommended in the case of lamivudine resistance, while tenofovir disoproxil fumarate (TDF) is recommended for ADV or entecavir (ETV) resistance. TDF is currently not available in Korea. ADV+ETV combination therapy may be a viable alternative to TDF in patients with either ADV or ETV resistance. However, the efficacy of ADV+ETV combination therapy in patients with CHB and multidrug resistance is unclear. This study investigated the efficacy of ADV+ETV combination therapy in patients with multidrug resistance.

METHODS:

Twenty-five patients were enrolled and were administered ADV+ETV combination therapy for at least 6 months. Blood was drawn at baseline and at 3, 6, 9, and 12 months after commencing treatment, and the following blood parameters were analyzed: alanine transaminase, hepatitis B e-antigen (HBeAg), anti-hepatitis B e-antigen, and hepatitis B virus (HBV) DNA levels. The initial virological response (IVR) was defined as an HBV DNA level of <4 log(10) copies/mL after 6 months of combination therapy.

RESULTS:

The IVR rate was 76%. The proportion of patients with a high viral load (=5.0 log) dropped from 76% at baseline to only 5% after 6 months of treatment. The biochemical response rate during the first 6 months was 71%. HBeAg was lost in 2 patients (10%).

CONCLUSIONS:

ADV+ETV combination therapy induced a good IVR in CHB patients who were refractory to more than 2 antiviral agents. This regimen may be a good alternative to TDF in Korea, where that drug is not available.

StephenW

韩国J肝胆病杂志。 2012 03 18（1）:75-83。出处2012年03月22日。

阿德福韦和恩替卡韦联合治疗与核苷难治性乙型肝炎患者的疗效高

资料来源：http://www.ncbi.nlm.nih.gov/pubmed/22511906

来源：内科，忠北国立大学医院，忠北国立大学医学院，清州，韩国。

抽象

背景/目的：

新开发的和强有力的抗病毒药物，患有耐药性的问题。多药耐药是治疗慢性乙型肝炎（CHB）患者的一个主要障碍。行为肝病指引，阿德福韦（ADV），研究在与美国商会添加治疗拉米夫定耐药的情况下，建议，而富马酸替诺福韦酯（TDF的）建议副词或恩替卡韦（ETV）电阻。 TDF的是目前在韩国上市。 ADV +教育电视联合治疗可能是一个可行的选择，在TDF的副词或ETV耐药患者。然而，ADV +教育电视联合治疗CHB和耐药患者的疗效目前还不清楚。本研究耐药病人阿德福韦+教育电视联合疗法的疗效。

方法：

二十五名患者参加至少6个月进阶+教育电视结合治疗和管理。血画在基线和3，6，9，12个月后开始治疗，下面的血液参数进行了分析：谷丙转氨酶，乙肝E-抗原（HBeAg），抗B型肝炎e抗原，乙肝乙型肝炎病毒（HBV）DNA水平。初始病毒学应答（IVR）被定义为HBV DNA水平<4日志（10）联合治疗6个月后拷贝/毫升。

结果：

的IVR率为76％。 6个月的治疗后，高病毒载量（= 5.0日志）患者的比例从基线时的76％下降到只有5％。前6个月期间的生化反应率为71％。 HBeAg的丢失2例（10％）。

结论：

ADV +教育电视联合治疗诱导难治超过2抗病毒药物的慢性乙型肝炎患者的良好的IVR。这个方案可能是华盈在韩国，该药物是没有一个很好的选择。

咬牙硬挺

学术界分歧不少

StephenW

回复 咬牙硬挺 的帖子

tenofovir尚未获批准在韩国(或日本).

林家女

这个翻译看得好困难啊，比看英文还困难

StephenW

回复 林家女 的帖子

同意。机器翻译