亚裔乙肝患者B基因型比C型患者在病情和治疗上都好

liver411

(谢谢帮忙翻译) Among Asians HBV Genotype B Has Slower Disease Progression and Better Treatment Response Than Genotype C HBV can now be sequenced into 7 major genotypes designated A to G. Two recent studies among Chinese and Japanese subjects indicate that genotype B disease has a slower progression and a better treatment response than the more common genotype in these populations, genotype C. Sumi et al found that among 254 patients with biopsy-proven chronic liver disease, genotype B patients were significantly less likely to be HBeAg+ (43% vs. 71%) or to have stage 3 or 4 fibrosis (13% vs. 33%) compared with genotype C patients. Similarly, the cumulative rate of anti-HBe seroconversion was significantly greater for genotype B cases (53% vs. 26% at 2 years). Stepwise multivariate analysis showed that HBV genotype was an independent predictor of HBe seroconversion. Of note, the beneficial effect of genotype B was observed only in patients <45, and patients who had advanced disease related to genotype B were significantly older than those of genotype C. This suggests that although patients with genotype B have earlier HBe seroconversion and slower progression to advanced fibrosis or HCC, the life-long risk of these deleterious outcomes may not differ among genotypes. This implies that disease progresses, albeit more slowly, even after HBe seroconversion and that the clinical advantage of genotype B may be overcome with increased duration of infection. Wai et al. provide evidence for a different advantage of genotype B, namely an improved sustained response to IFN. In a retrospective analysis of a previously reported clinical trial, it was shown that the IFN response rate (loss of HBV DNA by hybridization assay or loss of HBeAg at 6 months) was 39% for HBV genotype B patients and 17% for genotype C patients (P = .03); among patients with elevated pretreatment ALT, the relative response rates by genotype were 57% vs. 21% (P = .019). Importantly, multivariate analysis showed HBV genotype B to be an independent predictor of treatment response similar to that of pretreatment ALT elevation and low pretreatment HBV DNA level. It is recommended by the authors that stratification for HBV genotypes should be considered in future clinical trials of antiviral therapy and this seems very reasonable. 01/08/03 Source HJ Alter. Hepatology Highlights. Hepatology 2003 (January). Vol 37 No 1. References Sumi et al Hepatology 2003;37:19-26. Wai et al. Hepatology 2002;36:1425-1430. (内部交流)

zephyr

Among Asians HBV Genotype B Has Slower Disease Progression and Better Treatment Response Than Genotype C 在亚裔人群中，乙肝B基因型相对C基因型病情恶化速度慢并且治疗效果好 HBV can now be sequenced into 7 major genotypes designated A to G. Two recent studies among Chinese and Japanese subjects indicate that genotype B disease has a slower progression and a better treatment response than the more common genotype in these populations, genotype C. 乙肝可以分为从A到G的7种基因型。近来关于中国人和日本人的两项研究表明：乙肝B基因型相对C基因型病情恶化速度慢并且治疗效果好，在这些人群中，C基因型的更普遍。 Sumi et al found that among 254 patients with biopsy-proven chronic liver disease, genotype B patients were significantly less likely to be HBeAg+ (43% vs. 71%) or to have stage 3 or 4 fibrosis (13% vs. 33%) compared with genotype C patients. Similarly, the cumulative rate of anti-HBe seroconversion was significantly greater for genotype B cases (53% vs. 26% at 2 years). Sumi等发现在经肝活检确认的254名乙肝患者中，B基因型和C基因型相比，HBeAg+比例为43%：71%，3或4级纤维化比例为13%：33%。同时，两年内e抗体的累计血清转化率为53%：26%。 Stepwise multivariate analysis showed that HBV genotype was an independent predictor of HBe seroconversion. Of note, the beneficial effect of genotype B was observed only in patients <45, and patients who had advanced disease related to genotype B were significantly older than those of genotype C. This suggests that although patients with genotype B have earlier HBe seroconversion and slower progression to advanced fibrosis or HCC, the life-long risk of these deleterious outcomes may not differ among genotypes. 更进一步的分析表明：HBV基因型是e抗原的血清转化的一个独立预测因素。值得关注的是，B基因型的效果只表现在那些小于45岁的患者身上，B基因型患者中患有更严重肝病的年龄要比C基因型患者的年龄大的多。这意味着，尽管B基因型患者e抗原血清转化较早，并且演化成深度纤维化和肝癌的速度较慢，整个生命期内乙肝恶化的危险并不因为基因型的不同而有所差别。 This implies that disease progresses, albeit more slowly, even after HBe seroconversion and that the clinical advantage of genotype B may be overcome with increased duration of infection. 这个结果暗示，B基因型患者在e抗原血清转化后，虽然恶化速度变慢，但病情仍然在恶化；随着感染时间的增长，B基因型的优势逐渐消失。 Wai et al. provide evidence for a different advantage of genotype B, namely an improved sustained response to IFN. In a retrospective analysis of a previously reported clinical trial, it was shown that the IFN response rate (loss of HBV DNA by hybridization assay or loss of HBeAg at 6 months) was 39% for HBV genotype B patients and 17% for genotype C patients (P = .03); among patients with elevated pretreatment ALT, the relative response rates by genotype were 57% vs. 21% (P = .019). Wai等同时发现了B基因型的另一个优势，即对IFN持久效果的改善。在对上述实验的回馈分析中，IFN有效率(通过杂交实验HBV DNA减少或者6个月内e抗原减少),B基因型与C基因型相比为39%：17%(P=.03);对于那些治疗前ALT升高了的患者，相对有效率为57%：21%(P=.019). Importantly, multivariate analysis showed HBV genotype B to be an independent predictor of treatment response similar to that of pretreatment ALT elevation and low pretreatment HBV DNA level. It is recommended by the authors that stratification for HBV genotypes should be considered in future clinical trials of antiviral therapy and this seems very reasonable. 多变量分析表明，HBV B基因型是治疗效果的一个独立预测因素，也是治疗前ALT升高和低的治疗前HBV DNA水平的独立预测因素。作者认为，在以后的抗病毒疗法实验中应该考虑到HBV基因型的不同，这是非常重要的。 01/08/03 Source HJ Alter. Hepatology Highlights. Hepatology 2003 (January). Vol 37 No 1. References Sumi et al Hepatology 2003;37:19-26. Wai et al. Hepatology 2002;36:1425-1430.

[此贴子已经被作者于2003-1-15 20:16:10编辑过]

zephyr

第一次翻译，请大家帮忙看看

可可

谢谢zephyr的辛勤付出.译得很好.十分感谢!
下次还要找你噢.

以前有资料显示.B型基因预后比C型基因预后要稳定. C型基因更容易产生变异.

[此贴子已经被作者于2003-1-14 17:35:56编辑过]

zephyr

pretreatment 在医学上怎么翻译？

nighthawk

pretreatment: 治疗前