高基线病毒载量≥9 log10拷贝/ mL)患者替诺240周的疗效

StephenW

Hepatology. 2013 Jan 30.
doi: 10.1002/hep.26277. [Epub ahead of print]
Efficacy of tenofovir disoproxil fumarate at 240 weeks in patients with
chronic hepatitis b with high baseline viral load (≥ 9 log10 copies/mL).

高基线病毒载量≥9 log10拷贝/ mL)患者替诺240周的疗效
Gordon SC, Krastev Z, Horban A, Petersen J, Sperl J, Dinh P, Martins EB,
Yee LJ, Flaherty JF, Kitrinos KM, Rustgi VK, Marcellin P. Source Henry Ford
Health System, Detroit, MI, USA. [email protected].

Abstract
We evaluated the antiviral response of patients with chronic hepatitis B
who had baseline high viral load (HVL), defined as having hepatitis B virus
(HBV) DNA = 9 log(10) copies/mL, following 240 weeks of tenofovir
disoproxil fumarate (TDF) treatment. A total of 641 HBeAg-negative and
HBeAg-positive patients (129 with HVL) received 48 weeks of TDF 300 mg (HVL
n=82) or adefovir dipivoxil (ADV) 10 mg (HVL n=47), followed by open-label
TDF for an additional 192 weeks. Patients with confirmed HBV DNA = 400
copies/mL on or after Week 72 had the option of adding emtricitabine (FTC).
By Week 240, 98.3% of HVL and 99.2% of non-HVL patients on treatment
achieved HBV DNA <400 copies/mL. Both groups had similar rates of
histologic regression between baseline and Week 240. Patients with HVL
generally took longer to achieve HBV DNA <400 copies/mL than non-HVL
patients, but by Week 96 the percentages of patients with HBV DNA <400
copies/mL were similar in both groups. Among HVL patients, time to
achieving HBV DNA <400 copies/mL was shorter among those initially
receiving TDF compared to ADV. No patient with baseline HVL had persistent
viremia at Week 240 or amino acid substitutions associated with TDF
resistance.

Conclusion: Chronic hepatitis B patients with HVL can achieve
HBV DNA negativity with long-term TDF treatment, although time to HBV DNA
<400 copies/mL may be longer relative to patients with non-HVL. (HEPATOLOGY
2013.). Copyright © 2013 American Association for the Study of Liver
Diseases. PMID: 23364953 [PubMed - as supplied by publisher]

StephenW

我们评估了慢性乙型肝炎患者的抗病毒反应
谁了基线高病毒载量（HVL），定义为B型肝炎病毒
（HBV）DNA =9日志（10）拷贝/ ml，240周的替诺福韦
诺福韦酯（TDF）治疗。总共641例HBeAg阴性和
HBeAg阳性患者（129 HVL）接受48周的TDF300毫克（HVL
82例）或阿德福韦酯（ADV）10毫克（HVL例47），接着由开放标签
TDF的一个额外的192周。患者证实HBV DNA= 400
拷贝/毫升或72周后加入恩曲他滨（FTC）的选项。
240周，HVL98.3％和99.2％的非HVL病人的治疗
达到HBV DNA <400拷贝/ ml。这两个群体也有类似率
组织学的回归基线和周240之间。患者HVL
一般需要较长的时间达到HBV DNA <400拷贝/ ml比非HVL
患者，但96周的患者HBV DNA <400的百分比
拷贝/ ml两组相似。在的HVL患者，的时间
达到HBV DNA <400拷贝/ ml是在那些最初短
接受TDF相比，ADV。无患者基线HVL有持续性
病毒血症星期240或氨基酸取代与TDF关联
性。结论：慢性乙肝患者可以达到与HVL
长期TDF治疗HBV DNA转阴，虽然时间HBV DNA
<400拷贝/ ml的患者与非HVL可能是更长的时间相对。