疗效恩替卡韦治疗HBeAg阳性慢性乙型肝炎患者事先暴露于干扰

StephenW

Efficacy of entecavir therapy for HBeAg-positive chronic hepatitis B patients with prior exposure to interferon or nucleos(t)ide analogues
Article in Hepatology Research · September 2015 with 7 Reads
Impact Factor: 2.74 · DOI: 10.1111/hepr.12600

    1st Kuo-Chih Tseng
    31.53 · Tzu Chi University
    2nd Chih-Wei Tseng
    31.36 · Buddhist Tzu Chi General Hospital

    3rd Tsai-Yuan Hsieh
    Last Jia-Horng Kao
    50.09 · National Taiwan University

Abstract
Aims:
The efficacy of entecavir (ETV) in treatment-experienced chronic hepatitis-B-virus (CHB) patients remains unclear. We evaluated the therapeutic responses and virological breakthrough following ETV treatment in hepatitis B e-antigen (HBeAg)-positive CHB patients with prior exposure to interferon or nucleos(t)ide analogue and treatment-naïve patients.

Methods:
This was a retrospective, multi-center study of treatment (>1 year) with 0.5 mg ETV in 248 treatment-naïve and 48 treatment-experienced HBeAg-positive CHB patients (70.5% male; mean age, 40.5 years). The rates of undetectable HBV DNA, HBeAg loss, and virological breakthrough were analyzed.

Results:
The median duration of ETV treatment was 27.3 months (18.4 to 34.5 months). The rate of HBeAg loss was 41.9% (104/248) in treatment-naïve and 45.8% (22/48) in treatment-experienced patients. The baseline serum HBV DNA and alanine aminotransferase levels were significant predictors for HBeAg loss (P = 0.01 and P = 0.04, respectively). There was no statistical difference between the groups in the rates of undetectable HBV DNA and HBeAg loss at any time point. Virological breakthrough occurred in 1.6% (4/248) of treatment-naïve and 8.3% (4/48) of treatment-experienced patients. The four treatment-experienced patients with virological breakthrough had prior lamivudine treatment. After excluding those treated with interferon, lamivudine-experienced patients had a significantly greater of virological breakthrough compared to treatment-naïve patients (log-rank test, P = 0.034; univariate Cox regression, P = 0.047).

Conclusions:
ETV-treatment efficacy, including virological response and HBeAg loss, was comparable between treatment-naïve and treatment-experienced HBeAg-positive CHB patients. Lamivudine-experienced patients had a higher risk of virological breakthrough than treatment-naïve patients. This article is protected by copyright. All rights reserved.

StephenW

疗效恩替卡韦治疗HBeAg阳性慢性乙型肝炎患者事先暴露于干扰素或核苷（酸）类似物
文章在肝病研究·2015年九月7读取
影响因子：2.74·DOI：10.1111 / hepr.12600

    1日郭芷曾雅妮
    31.53·慈济大学
    第二芷蔚曾
    31.36·佛教慈济综合医院

    第三蔡渊谢
    最后贾泓花王
    50.09·国立台湾大学

抽象的
目的：
恩替卡韦（ETV）的治疗经验的慢性乙型肝炎病毒（CHB）患者的疗效尚不清楚。我们评估的治疗反应和病毒学突破之后ETV治疗乙型肝炎e抗原（HBeAg）阳性阳性CHB患者前暴露于干扰素或核苷（酸）类似物IDE和治疗的初治患者。

方法：
这是治疗（> 1年）的0.5毫克ETV 248治疗天真和48治疗经验的HBeAg阳性慢性乙型肝炎患者的回顾性，多中心研究（70.5％为男性，平均年龄40.5岁）。检测不到的HBV DNA，HBeAg消失和病毒学突破率进行了分析。

结果：
ETV治疗时间中位数为27.3个月（18.4至34.5个月）。 HBeAg阴转率分别为41.9％（二百四十八分之一百〇四）在治疗初治和45.8％（22/48）在治疗经验的患者。基线血清HBV DNA和丙氨酸转氨酶水平显著的预测为HBeAg消失（P = 0.01和P = 0.04，分别）。有在任何时间点的群体中检测不到HBV DNA和HBeAg转阴率差异无统计学意义。病毒学突破发生在治疗初治和治疗经验的患者的8.3％（4/48），1.6％（二百四十八分之四）。四个治疗经验的患者有病毒学突破了之前拉米夫定治疗。不包括干扰素治疗后，拉米夫定经验的患者有显著更大的病毒学突破相比，初治患者（log-rank检验，P = 0.034;单变量Cox回归，P = 0.047）。

结论：
ETV-治疗效果，包括病毒学应答和HBeAg消失，是可比治疗初治和治疗经验的HBeAg阳性慢性乙型肝炎患者之间。拉米夫定经验的患者有病毒学突破，比初治患者的风险较高。这篇文章是受版权保护的。版权所有。
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