病毒载量和ALT与恩替卡韦治疗慢性乙肝血清学反应相关因素

肝胆速递

http://www.ncbi.nlm.nih.gov/pubmed/22989322
J Gastroenterol Hepatol. 2012 Sep 18. doi: 10.1111/j.1440-1746.2012.07269.x. [Epub ahead of print]
Viral load and ALT correlate with serologic response in chronic hepatitis B patients treated with entecavir.
Wang CC, Tseng KC, Peng CY, Hsieh TY, Lin CL, Su TH, Tseng TC, Hsu CS, Lin HH, Kao JH.
Source

Department of Hepatology, Buddhist Tzu Chi General Hospital, Taipei Branch and School of Medicine, Tzu Chi University, Hualien, Taiwan.
Abstract
BACKGROUND AND AIM:

Although entecavir has been shown to have good efficacy and low resistance for the treatment of chronic hepatitis B (CHB), factors associated with a favorable response remain unknown.
METHODS:

This was a retrospective, multicenter study of 248 treatment-naïve HBeAg-positive patients (69.4% male; median age, 39.4 years) treated with entecavir for more than 1 year, and 15.7% of them had cirrhosis at baseline. The primary endpoints were HBeAg loss and/or seroconversion.
RESULTS:

The median baseline levels of alanine aminotransferase (ALT) and HBV DNA were 201 U/L (range, 27-2,415 U/L) and 7.6 log(10)  IU/mL (range, 2.2-13.18), respectively. The median treatment period was 25.3 months (range, 12-69.6). The rates of ALT normalization at years 1, 2 and 3 were 83.1%, 87.9% and 94.9%, respectively. The cumulative rates of HBeAg loss at years 1, 2 and 3 were 20.3%, 38.0% and 48.9%, respectively. The rates of undetectable HBV DNA at years 1, 2 and 3 were 52.1%, 78.9% and 82.5%, respectively. Using Cox proportional hazards model, multivariate analysis showed that baseline ALT >5-time the upper limit of normal, and viral load were independent factors associated with HBeAg loss (hazard ratio: 1.81, and 0.812; 95% confidence interval: 1.062-3.085; 0.7-0.942, respectively).
CONCLUSION:

Entecavir treatment for 3 years can achieve good biochemical and virologic responses in HBeAg-positive CHB patients, but has a modest effect on HHBeAg loss and/or seroconversion. In addition, baseline serum ALT and HBV DNA levels are independent factors associated with favorable treatment responses.

肝胆速递

胃肠病学杂志肝脏病杂志。 2012年9月18日。 DOI：10.1111/j.1440-1746.2012.07269.x。 [EPUB的提前打印]
病毒载量和ALT与恩替卡韦治疗慢性乙型肝炎患者的血清学反应。
王CC，曾KC，彭CY，谢TY，CL林，苏TH，曾TC，许CS，林HH，高JH。
源

佛教慈济综合医院台北分行及医学院，慈济大学，花莲，台湾的杂志，。
抽象
背景与目的：

虽然恩替卡韦治疗慢性乙型肝炎（CHB）已被证明有良好的疗效和低电阻，反应良好相关因素仍然不明。
方法：

这是一个回顾性，多中心研究，248治疗初治的HBeAg阳性患者（69.4％为男性，平均年龄为39.4岁）与恩替卡韦治疗1年以上，15.7％的人有​​肝硬化基线。主要终点是HBeAg消失和/或血清学转换。
结果：

丙氨酸氨基转移酶（ALT）和HBV DNA的基线水平中位数分别为201 U / L（范围为27-2,415 U / L）和7.6日志（10）IU / mL（范围2.2-13.18），分别。平均治疗时间为25.3个月（范围为12-69.6）。 ALT复常率分别为83.1％，87.9％和94.9％，1年，2和3。累计HBeAg转阴率在1年，2和3分别为20.3％，38.0％和48.9％，分别。检测不到HBV DNA在1年，2和3分别为52.1％，78.9％和82.5％，分别。使用Cox比例风险模型，多因素分析显示，基线ALT> 5倍正常上限的，和病毒载量与HBeAg消失（危险比：1.81，和0.812的独立危险因素，95％的置信区间1.062-3.085; 0.7-0.942，分别）。
结论：

HBeAg阳性CHB患者，恩替卡韦治疗3年可实现良好的生化学和病毒学反应，但有一个大小适中的的影响HHBeAg损失和/或血清学转换。此外，基线血清ALT和HBV DNA水平与良好的治疗反应相关的独立危险因素。