恩替卡韦单药治疗与拉米夫定单药治疗慢性乙型肝炎核苷（

StephenW

J Korean Med Sci. 2018 Feb 19;33(8):e63. doi: 10.3346/jkms.2018.33.e63.
A Multicenter Study of the Antiviral Efficacy of Entecavir Monotherapy Compared to Lamivudine Monotherapy in Children with Nucleos(t)ide-naïve Chronic Hepatitis B.Lee KJ1, Choe BH2, Choe JY2, Kim JY3, Jeong IS4, Kim JW1, Yang HR1, Chang JY1, Kim KM4, Moon JS1, Ko JS5.
Author information
1Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.2Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea.3Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.4Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine Seoul, Korea.5Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. [email protected].

AbstractBACKGROUND: The aim of this study was to compare the long-term efficacy of entecavir (ETV) and lamivudine (LAM) therapy in children with chronic hepatitis B (CHB) who had not received nucleoside analogue treatment.
METHODS: In this multicenter, retrospective study, we included pediatric CHB patients younger than 20 years who received ETV or LAM treatment for at least 12 months and had no concomitant diseases. All of the patients were followed up every 1 to 3 months. At each visit, the patients underwent clinical evaluation and biochemical testing.
RESULTS: Eight (53.3%), 14 (93.3%), and 2 (15.4%) of the ETV-treated patients achieved virologic suppression, alanine aminotransferase (ALT) normalization and hepatitis B e antigen (HBeAg) seroconversion, respectively, at 1 year. In the ETV group, the cumulative rate of virologic suppression at 3 years was 91.7%, which was significantly higher than that in the LAM group (P < 0.001). The mean duration of treatment before virologic suppression was shorter in the ETV group than in the LAM group (P = 0.040). The cumulative rate of seroconversion in the ETV group at 3 years was 39.4%, which was not significantly different from that in the LAM group (P = 0.439). The ETV group showed lower cumulate rates of virologic breakthrough (33.3% at 6 years) and genotypic mutation than the LAM group (P = 0.033 and P = 0.011, respectively).
CONCLUSION: ETV is superior to LAM in pediatric CHB treatment because of its higher virologic suppression rate and lower cumulative rates of virologic breakthrough and genotypic mutation.


KEYWORDS: Children; Chronic Hepatitis B; Entecavir; Lamivudine

PMID:29441755PMCID:PMC5809752 [Available on 2018-02-19]DOI:10.3346/jkms.2018.33.e63

StephenW

J Korean Med Sci。 2018年2月19日; 33（8）：e63。 doi：10.3346 / jkms.2018.33.e63。
恩替卡韦单药治疗与拉米夫定单药治疗慢性乙型肝炎核苷（胺）初治儿童抗病毒疗效的多中心研究
Lee KJ1 Choe BH2 Choe JY2 Kim JY3 Jeong IS4 Kim JW1 Yang HR1 Chang JY1 Kim KM4 Moon JS1 Ko JS5。
作者信息

1
    首尔大学医学院小儿科，韩国首尔。
2
    韩国大邱庆北国立大学医学部小儿科。
3
    韩国城南首尔大学医学院汉城国立大学盆唐医院小儿科。
4
    韩国首尔蔚山医科大学牙山医学中心儿科医院小儿科。
五
    首尔大学医学院小儿科，韩国首尔。 [email protected]。

抽象
背景：

本研究的目的是比较恩替卡韦（ETV）和拉米夫定（LAM）治疗对未接受核苷类似物治疗的慢性乙型肝炎（CHB）儿童的长期疗效。
方法：

在这项多中心的回顾性研究中，我们纳入了年龄小于20岁且接受ETV或LAM治疗至少12个月并且没有伴随疾病的小儿CHB患者。所有患者均每1〜3个月随访一次。在每次就诊时，患者均接受临床评估和生化检测。
结果：

1年时分别有8例（53.3％），14例（93.3％）和2例（15.4％）ETV治疗的患者分别达到了病毒学抑制，丙氨酸转氨酶（ALT）正常化和乙型肝炎e抗原（HBeAg）血清学转换。在ETV组中，3年时病毒学抑制的累积率为91.7％，明显高于LAM组（P <0.001）。 ETV组病毒学抑制前的平均治疗时间短于LAM组（P = 0.040）。 ETV组3年血清学转换率为39.4％，与LAM组无显着性差异（P = 0.439）。 ETV组病毒学突破（6年33.3％）和基因型突变的累积发病率低于LAM组（分别为P = 0.033和P = 0.011）。
结论：

ETV在小儿CHB治疗中优于LAM，因为其较高的病毒学抑制率和较低的病毒学突破和基因型突变的累积率。
关键词：

儿童;慢性乙型肝炎;恩替卡韦;拉米夫定

结论：
    29441755
PMCID：
    PMC5809752
    [2018-02-19可用]
DOI：
    10.3346 / jkms.2018.33.e63

StephenW

https://jkms.org/DOIx.php?id=10.3346/jkms.2018.33.e63