拉米夫定停药后的病毒学应答的拉米夫定耐药患者拉米夫定

StephenW

J Med Virol. 2016 Jun 30. doi: 10.1002/jmv.24616. [Epub ahead of print]
Durability of the virological response after lamivudine discontinuation in lamivudine-resistant patients with a complete virological response after lamivudine and adefovir combination therapy.Kim MN1, Park JY2,3,4, Ahn SH2,3,4, Kim BK2,3,4, Kim SU2,3,4, Kim DY2,3,4, Han KH2,3,4.
Author information

• 1Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
• 2Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
• 3Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
• 4Yonsei Liver Center, Yonsei University Health System, Seoul, Korea.
  

AbstractWe investigated the durability of virological response after lamivudine (LAM) discontinuation in LAM-resistant chronic hepatitis B (CHB) patients with complete virological response after LAM-adefovir (ADV) combination therapy. We enrolled 58 patients switched to ADV monotherapy with undetectable viral loads (< 12 IU/ml) and normal alanine aminotransferase levels after ADV add-on combination treatment for at least 6 months in LAM-resistant CHB patients. Virologic relapse was defined as HBV DNA detection at more than 20 IU/ml by quantitative polymerase chain reaction determined on two consecutive measurements. During median 40.9 months of follow-up (range 11.5-79.0 months), 7 (12.1%) patients experienced virologic relapse. The cumulative rate of virologic relapse at 3 and 5 years was 5.5% and 22.4%, respectively. Two patients had elevated alanine aminotransferase during virologic relapse. These 7 patients with virologic relapse had undetectable HBV DNA after switching to tenofovir therapy. In our study, switching to ADV monotherapy resulted in sustained HBV DNA suppression in 87.9% of the patients during median 40.9 months follow-up. This adapting step-down strategy, switching from combination therapy to monotherapy in virologically suppressed CHB patients with stable liver disease, may reduce the cost burden and the risk of potentially harmful effects of combination therapy. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.


KEYWORDS: Antiviral agents; Hepatitis B virus; Resistance.DR

StephenW

医学杂志病毒学杂志。 2016年30月：10.1002 / jmv.24616。 [打印EPUB提前]
拉米夫定停药后的病毒学应答的拉米夫定耐药患者拉米夫定和阿德福韦联合治疗后，一个完整的病毒学应答的耐久性。
金MN1，公园JY2,3,4，安贞焕SH2,3,4，金BK2,3,4，金SU2,3,4，金DY2,3,4，韩KH2,3,4。
作者信息

    内科，盆唐CHA医疗中心，CHA大学城南，韩国教研室。
    内科，医学延世大学，首尔，韩国教研室。
    消化3Institute，医学院，韩国首尔延世大学。
    4Yonsei肝病中心，延世大学健康系统，韩国首尔。

抽象

我们研究了LAM耐药慢性乙型肝炎（CHB）的患者LAM-阿德福韦（ADV）联合治疗后完全病毒学应答拉米夫定（LAM）停药后病毒学应答的耐久性。我们招收58例LAM耐药慢性乙型肝炎患者改用ADV单药治疗与检测不到病毒载量（<12 IU / ml）和正常的谷丙转氨酶水平ADV附加联合治疗后至少6个月。病毒学复发是在超过20 IU / ml的通过连续两次的测量来确定定量聚合酶链反应定义为HBV DNA检测。在中位数40.9个月的随访（范围11.5-79.0个月），7（12.1％）患者出现病毒学复发。病毒学复发中的3和5年的累积率分别为5.5％和22.4％。两名患者复发病毒学中谷丙转氨酶升高。这7例病毒学复发改用替诺福韦治疗后未检出HBV DNA。在我们的研究中，切换到单药治疗ADV期间平均40.9个月随访导致持续HBV DNA抑制的患者的87.9％。此调整降压的策略，从联合治疗切换到单药治疗中病毒学抑制慢性乙型肝炎患者的稳定肝病，可降低成本负担和组合疗法的潜在有害影响的风险。本文由版权保护。版权所有。

本文由版权保护。版权所有。
关键词：

抗病毒药。乙型肝炎病毒; Resistance.DR