阿德福韦成果附加的长达5年拉米夫定抢救治疗的患者拉米夫

StephenW

J Gastroenterol Hepatol. 2015 Jul 22. doi: 10.1111/jgh.13046. [Epub ahead of print]
Outcome of adefovir add-on lamivudine rescue therapy of up to 5 years in patients with lamivudine-resistant chronic hepatitis B.Kim SB1, Kim SU1,2,3, Kim BK1,2,3, Park JY1,2,3, Kim DY1,2,3, Ahn SH1,2,3, Han KH1,2,3.
Author information

• 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
• 2Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
• 3Liver Cirrhosis Clinical Research Center, Seoul, Korea.
  

AbstractBACKGROUND AND AIM: We investigated the long-term efficacy of adefovir add-on lamivudine rescue therapy in lamivudine-resistant chronic hepatitis B (CHB) and the optimal cutoff HBV DNA level that predicts complete virological response (CVR) among patients without CVR after 1 year of treatment.
METHODS: We reviewed 167 lamivudine-resistant CHB patients who received adefovir add-on rescue therapy for up to 5 years. Multivariate analysis, area under the receiver operating characteristic curves, and Youden index were used.
RESULTS: Median age was 47.0 years; 112 patients were male. Median baseline HBV DNA level was 6.6 log10 IU/ml; hepatitis B e antigen (HBeAg) was positive in 130 (77.4%) patients. Five-year CVR, alanine aminotransferase normalization, HBeAg seroconversion, and adefovir resistance rates were 86.9%, 92.5%, 16.7%, and 6.0%, respectively. One-year HBV DNA level independently associated with CVR. Optimal cutoff HBV DNA level to predict CVR among patients who failed to achieve CVR at 1 year was 800 IU/ml (area under receiver operating characteristic curve 0.752; sensitivity 49.3%, specificity 93.5%). During the 5-year treatment, 92.1% of patients with favorable response (HBV DNA <800 IU/ml at 1 year) achieved CVR; 45.6% achieved CVR among suboptimal responders (HBV DNA ≥800 IU/ml at 1 year) (P < 0.001).
CONCLUSIONS: CVR or HBV DNA level <800 IU/ml after 1-year adefovir add-on lamivudine rescue therapy can favorably predict CVR. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.

StephenW

Gastroenterol肝脏病。 2015年22月DOI：10.1111 / jgh.13046。 [打印EPUB的提前]
阿德福韦成果附加的长达5年拉米夫定抢救治疗的患者拉米夫定耐药的慢性乙型肝炎
金SB1，金SU1,2,3，金BK1,2,3，公园JY1,2,3，金DY1,2,3，安贞焕SH1,2,3，韩KH1,2,3。
作者信息

    教研室内科，医学延世大学，首尔，韩国。
    2中国科学院消化内科，医学，韩国首尔延世大学。
    3Liver肝硬化临床研究中心，韩国首尔。

抽象
背景与目的：

我们研究阿德福韦的长期疗效附加拉米夫定抢救治疗拉米夫定耐药的慢性乙型肝炎（CHB）和预测之间的患者无CVR治疗1年后完全病毒学应答（CVR）的最佳临界HBV DNA水平。
方法：

我们回顾谁接受阿德福韦附加抢救治​​疗长达5年167拉米夫定耐药的慢性乙肝患者。多变量分析中，受试者工作特性曲线下的面积，并Youden指数被使用。
结果：

平均年龄为47.0岁; 112例患者均为男性。平均基线HBV DNA水平为6.6日志10 IU / ml的;乙肝e抗原（HBeAg）是130（77.4％）患者阳性。五CVR，谷丙转氨酶正常化，HBeAg血清学转换，和阿德福韦耐药率分别为86.9％，92.5％，16.7％和6.0％，分别为。一年HBV DNA水平与独立有关的CVR。最佳临界HBV DNA水平来预测CVR中谁没有达到CVR 1年的患者为800国际单位/毫升（下ROC曲线面积0.752;灵敏度49.3％，特异性为93.5％）。在5年的治疗，患者的良好应答（HBV DNA <800国际单位/毫升的1年）来实现CVR 92.1％; 45.6％达到次优的反应之间的CVR（HBV DNA≥800IU / ml的1年）（P <0.001）。
结论：

CVR或HBV DNA水平<800 IU 1年后/ ml的阿德福韦附加拉米夫定抢救治疗能够良好预测CVR。这篇文章是受版权保护的。版权所有。

这篇文章是受版权保护的。版权所有。