干扰拉米联用效果和拉米独用一样（7月26日于HIV&HBV）

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[B]干扰拉米联用效果和拉米独用一样
很多使用拉米和干扰素联合治疗乙肝的研究结果是不连贯的和具有结论性的。本研究旨在评价干扰素和拉米联用效果，并和单独使用拉米的效果进行对比。

80名患者使用拉米和干扰联用或拉米独用治疗。根据双盲原则，患者被随即进行分组。

每组拉米采用150 mg/天的剂量，服用96周。干扰素拉米联用组施以10 MU，每周3次，24周。

结果
联用组ALT复常早于拉米独用组。治疗结果显示，两组中HBVDNA的转阴率，ALT复常率和转阴率没有差别。两组的组织学改善都十分明显，但是拉米治疗过的病人纤维痕迹和炎症坏死活动要低得多。

结论
结论是，作者写道，在拉米基础上再使用干扰素不会增加治疗的效果。考虑到干扰素的副作用，这样的联合治疗看来并不十分便于E抗原阳性乙肝患者采用。

土耳其，亿兹磨尔，EGE医药大学，肠胃病学系
07/26/04

参考
美国 Akarca 和其他， 干扰－拉米联用和拉米独用效果相同，抗病毒治疗 9（3）：325-34. 七月 2004[/B]
Interferon-lamivudine Combination Is No Better Than Lamivudine Alone in Anti-HBe-positive Chronic Hepatitis B

Results of studies using lamivudine (Epivir-HBV) and interferon alfa (Intron A) combination in the treatment of chronic hepatitis B are not consistent or conclusive. This study aimed to evaluate the efficacy of interferon plus lamivudine use versus single lamivudine in anti-HBe-positive chronic hepatitis B.

Eighty patients were treated with either lamivudine or lamivudine plus simultaneously started interferon. Patients were assigned in groups according to random allocation rule.

Lamivudine was given 150 mg/day for 96 weeks in each group; interferon was administered 10 MU three times a week for 24 weeks in the combination therapy group.

Results
Alanine aminotransferase (ALT) normalization was achieved earlier in patients treated with lamivudine alone. At the end of treatment, there was no difference between the groups with respect to HBV DNA negativity, ALT normalization and breakthrough rate.

Histological improvement was remarkable in each group, but fibrosis score and necro-inflammatory activity were much lower in lamivudine-treated patients.

Conclusions
In conclusion, the authors write, 揂ddition of interferon to the lamivudine regimen does not increase the effectiveness of the treatment. Considering the side effects of interferon treatment, this combination seems not to be convenient for anti-HBe-positive chronic hepatitis B.?/span>


Division of Gastroenterology, Ege University Faculty of Medicine, Izmir, Turkey.

07/26/04

Reference
U S Akarca and others. Interferon-lamivudine combination is no better than lamivudine alone in anti-HBe-positive chronic hepatitis B. Antiviral Therapy 9(3): 325-34. June 2004.

[此贴子已经被作者于2004-7-27 18:27:11编辑过]