酗酒损害恩替卡韦治疗慢性乙型肝炎的生化反应

StephenW

http://hhdev.rockgarden.net/hbv-treatment/approved-hbv-drugs/3807-heavy-alcohol-use-impairs-biochemical-response-to-entecavir-for-chronic-hepatitis-b
Heavy Alcohol Use Impairs Biochemical Response to Entecavir for Chronic Hepatitis B

Published on Friday, 28 September 2012 00:00
Written by Liz Highleyman



While obese chronic hepatitis B patients and heavy drinkers did not have impaired virological response to entecavir (Baraclude), alcohol use did reduce the likelihood of alanine aminotransferase (ALT) normalization, according to study findings reported in the June 2012 issue of Clinical and Molecular Hepatology.

While obese chronic hepatitis B patients and heavy drinkers did not have impaired virological response to entecavir (Baraclude), alcohol use did reduce the likelihood of alanine aminotransferase (ALT) normalization, according to study findings reported in the June 2012 issue of Clinical and Molecular Hepatology.

Won Gil Chung from Kangbuk Samsung Hospital in Seoul and colleagues looked at the clinical impact of obesity and "hazardous alcohol use" on outcomes of entecavir treatment for chronic hepatitis B.

The investigators retrospectively analyzed medical records from 88 previously untreated hepatitis B patients who received entecavir between March 2007 and September 2009. About 70% were men, the average age was 47 years, and half were hepatitis B "e" antigen (HBeAg) positive. About 22% had liver cirrhosis, but those with decompensated disease were excluded, as were people with HIV or hepatitis C coinfection.

All patients included in the analysis were treated with 0.5 mg once-daily entecavir for more than 12 months. Body mass index (BMI) and scores on the Alcohol Use Disorders Identification Test (AUDIT) were obtained 6 months after the start of treatment. A BMI of 25 kg/m2 or more was the threshold for obesity and a total AUDIT score of 8 or more was the cutoff for hazardous alcohol use.
Results

    24 patients in the cohort (27%) were obese and 17 (19%) were classified as hazardous alcohol users.
    Complete virological response rates (< 300 HBV DNA copies/mL) were 47% at 3 months, 69% and 6 months, and 83% at 12 months after starting entecavir.
    Among the 44 initially HBeAg positive participants, complete virological response rates at these time points were 21%, 48%, and 71%, respectively, compared with 73%, 91%, and 96% for HBeAg negative patients.
    Seroconversion rates for the HBeAg positive group at the same time points were 21%, 25%, and 34%, respectively.
    Rates of complete virological response, HBeAg seroconversion, and ALT normalization did not differ significantly between obese individuals and those with normal BMI.
    Virological response and seroconversion rates were also similar between hazardous alcohol users and those who drank less or not at all.
    But the frequency of ALT normalization at 12 months was significantly lower for hazardous alcohol users, indicating ongoing liver inflammation (92% vs 71%; P=0.03).

"Obesity and hazardous alcohol drinking have no significant impact on the outcome of entecavir treatment," the study authors concluded. "However, the ALT normalization rate at 12 months after initiation of entecavir treatment was significantly lower among the hazardous alcohol users."

"Alcohol and obesity are well known for their noxious effect on the liver and expected to have the negative effect on entecavir efficacy," they added in their discussion. "However, contrary to our expectations, entecavir showed [a] satisfactory antiviral effect in the obese and hazardous alcohol use patients with chronic hepatitis B."

9/28/12

Reference

WG Chung, HJ Kim, YG Choe, et al. Clinical impacts of hazardous alcohol use and obesity on the outcome of entecavir therapy in treatment-naïve patients with chronic hepatitis B infection. Clinical and Molecular Hepatology 18(2):195-202. June 2012.

StephenW

酗酒损害恩替卡韦治疗慢性乙型肝炎的生化反应

发表于2012年9月28日（星期五）00:00
作者：利兹Highleyman的



虽然肥胖的慢性乙型肝炎患者和酗酒者没有病毒学应答受损，恩替卡韦（博路定），酒精的使用也降低谷丙转氨酶（ALT）正常化的可能性，根据研究结果，在2012年6月发行的临床和分子肝病报告。

虽然肥胖的慢性乙型肝炎患者和酗酒者没有病毒学应答受损，恩替卡韦（博路定），酒精的使用也降低谷丙转氨酶（ALT）正常化的可能性，根据研究结果，在2012年6月发行的临床和分子肝病报告。

韩元吉尔涌从江北三星医院在首尔和他的同事们看着肥胖的临床影响和“有害使用酒精的成果恩替卡韦治疗慢性B型肝炎

研究者回顾性分析了从88以前未经治疗的乙肝患者接受恩替卡韦2007年3月至2009年9月的医疗记录。约70％为男性，平均年龄为47岁，有一半是B型肝炎的“e”抗原（HBeAg）阳性。约22％有肝硬化，但那些被排除在外，失代偿性疾病的人感染艾滋病毒或丙型肝炎合并感染。

在分析所有患者0.5毫克每日一次超过12个月的恩替卡韦治疗。身体质量指数（BMI）和酒精使用障碍鉴别试验（AUDIT）的成绩获得了6个月后开始治疗。肥胖的体重指数为25 kg/m2或以上的门槛，总审计的8个或更多的得分是有害使用酒精的截止。
结果

    队列中的24例（27％）为肥胖，17（19％）被列为危险的饮酒者。
    完全病毒学应答率（<300 HBV DNA拷贝/ mL），在3个月的47％，69％，6个月，83％在12个月后开始恩替卡韦。
    在最初的44个HBeAg阳性的参与者，在这些时间点的完整的病毒学应答率分别为21％，48％和71％，分别比73％，91％，96％，HBeAg阴性患者。
    在同一时间点的HBeAg阳性组的血清阳转率分别为21％，25％和34％，分别为。
    不完整的病毒学应答，HBeAg血清学转换，ALT正常化率之间的肥胖者，体重指数正常者显着差异。
    病毒学应答率和血清转换率也相似之间危险的饮酒者和那些谁喝少用或不用。
    但在12个月ALT正常化的频率显着降低有害饮酒者，持续的肝脏炎症（92％比71％，P = 0.03）。

“肥胖和有害饮酒恩替卡韦治疗的结果并没有显着的影响，”该研究的作者得出结论。 “不过，ALT复常率在12个月后开始的恩替卡韦治疗显著降低危险的饮酒者中。”

“酒精和肥胖是众所周知的，其对肝脏的有害影响，并预计将有恩替卡韦治疗疗效的负面影响，”他们补充他们的讨论。 “然而，出乎我们的意料，恩替卡韦[A]令人满意的肥胖和有害使用酒精慢性乙型肝炎患者的抗病毒效果”

12年9月28日

参考

HJ金涌，WG，YG崔等。有害使用酒精和肥胖的结果，恩替卡韦治疗慢性B型肝炎感染的治疗初治患者的临床影响。临床和分子肝病学18（2）:195-202。 2012年6月。