序贯治疗拉米夫定其次是β干扰素的远期疗效核苷初治，乙

StephenW

Long-Term Outcome of Sequential Therapy with Lamivudine Followed by Interferon-β in Nucleoside-Naive, Hepatitis B e-Antigen-Positive Patients with Chronic Hepatitis B Virus Genotype C Infection                                To cite this article:
Enomoto Masaru, Nishiguchi Shuhei, Tamori Akihiro, Kozuka Ritsuzo, Hayashi Takehiro, Kohmoto Madoka Toyama, Jomura Hisato, Morikawa Hiroyasu, Murakami Yoshiki, Shiomi Susumu, and Kawada Norifumi. Journal of Interferon & Cytokine Research.                        August 2015,                                    35(8): 613-620.                    doi:10.1089/jir.2014.0234.   
   

                Published in Volume: 35 Issue 8: August 5, 2015

Author information
Masaru Enomoto,1
Shuhei Nishiguchi,2
Akihiro Tamori,1
Ritsuzo Kozuka,1
Takehiro Hayashi,1
Madoka Toyama Kohmoto,1
Hisato Jomura,3
Hiroyasu Morikawa,1
Yoshiki Murakami,1
Susumu Shiomi,4 and Norifumi Kawada1
1Department of Hepatology, Osaka City University Medical School, Osaka, Japan.
2Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
3Department of Internal Medicine, Wakakoukai Clinic, Osaka, Japan.
4Department of Nuclear Medicine, Osaka City University Medical School, Osaka, Japan.
Address correspondence to:
Dr. Masaru Enomoto
Department of Hepatology
Osaka City University Medical School1-4-3 Asahimachi
Abeno-ku
Osaka 545-8585
Japan
E-mail: [email protected]

Received 24 December 2014
Accepted 12 February 2015

ABSTRACT

It is unclear whether the combination of a nucleos(t)ide analog and interferon (IFN) is superior to monotherapy for treating chronic hepatitis B. In this study, we report the long-term outcomes of sequential therapy using lamivudine followed by IFN-β. This study included 24 hepatitis B e-antigen (HBeAg)-positive patients with chronic hepatitis B virus (HBV) genotype C infection who were treated with lamivudine alone for 16–32 weeks, then with both IFN-β and lamivudine for 4 weeks, and finally with IFN-β alone for 20 weeks. All patients were followed up for 7.1±2.8 years post-treatment. The rate of response, defined as transaminase normalization, HBeAg loss, and HBV DNA <104 copies/mL, was 5/24 (21%) at 24 weeks post-treatment. The patients with short-term responses were younger than those with no response (P=0.039). More short-term responders had undetectable HBV DNA at the start of IFN-β compared with the nonresponders (P=0.0059). Subsequently, 4 of the 5 short-term responders remained free of the need for further drug treatment for 4.2±3.5 years post-treatment; more short-term responders remained drug free than did nonresponders (P=0.035). In conclusion, the rate of response to sequential therapy was limited in HBeAg-positive patients with chronic HBV genotype C infection at 24 weeks post-treatment. In the majority of the short-term responders, however, the response was sustainable in the long term.

StephenW

序贯治疗拉米夫定其次是β干扰素的远期疗效核苷初治，乙肝e抗原阳性慢性乙型肝炎病毒基因型肝炎感染

举这篇文章：
榎本胜，西口修平，田森彰，小冢Ritsuzo，林武广，Kohmoto马多卡富山，Jomura寿人，森川裕康，村上良树，潮见进，和川田Norifumi。杂志干扰素与细胞因子研究。 2015年8月，35（8）：613-620。 DOI：10.1089 / jir.2014.0234。

发表在卷：35问题8：2015年8月5日
网上先于印刷版：2015年4月17日

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作者信息
榎本胜，1周平西口，2昭洋田森，1 Ritsuzo小冢，武广1林，1马多卡富山Kohmoto，1寿人Jomura，3裕康森川，1村上良树，1进潮见，4 Norifumi Kawada1
教研室肝病，大阪市立大学医学院，日本大阪。
教研室内科，医学学院兵库县西宫，日本。
3Department内科，Wakakoukai诊所，日本大阪。
4Department核医学，大阪市立大学医学院，日本大阪。
通讯地址：
榎本胜博士
肝病科
大阪市立大学医学院
1-4-3 Asahimachi
阿倍野区
大阪545-8585
日本
电子信箱：[email protected]
收到的2014年12月24日
接受2015年2月12日
摘要

目前还不清楚一个核苷（酸）类似物IDE和干扰素（IFN）的组合是否优于单药治疗慢性乙型肝炎在这项研究中，我们报道序贯疗法使用拉米夫定随后IFN-β的长期结果。这项研究包括24乙型肝炎e抗原（HBeAg）阳性阳性慢性乙型肝炎病毒（HBV）谁是单独拉米夫定治疗16-32周，然后用这两个IFN-β和拉米夫定4周C基因型感染，最后用单独的IFN-β为20周。所有患者随访7.1±2.8年全日制处理。反应的速率，其定义为转氨酶正常化，HBeAg消失，和HBV DNA <104拷贝/ ml，为5/24（21％），在24周治疗后。该患者的短期反应是年龄小于那些没有应答（P = 0.039）。更多的短期反应未检出HBV DNA的IFN-β的启动与无反应者（P = 0.0059）相比。接着，4 5短期应答器保持自由的，需要进一步的药物治疗为4.2±3.5年​​后处理;更多的短期反应仍然无药比无反应者做（P = 0.035）。总之，应对序贯治疗率是在HBeAg阳性慢性HBV C基因型感染在24周后处理的限制。在大多数的短期反应，然而，反应是可持续的长期。