拉米治疗E抗原阴性的慢性HBV2年后的持续应答

zasxz

Sustained Response After a 2-year Course of Lamivudine Treatment in HBeAg-negative Chronic HBV Patients


A major concern regarding lamivudine (Epivir-HBV) therapy for chronic hepatitis B is the potential for the rapid development of lamivudine -resistant HBV, often followed by relapse and HBV disease progression.

Nonetheless, lamivudine has demonstrated efficacy for the treatment of hepatitis Be antigen-negative chronic hepatitis B (e-CHB). However, treatment withdrawal after 1 year has been associated with a high rate of relapse while long-term treatment is associated with increasing risks of drug resistance.

In the present report, investigators outline their experience with treatment of 50 Chinese-Canadian patients with e-CHB.

All patients received lamivudine for 2 years. Treatment was withdrawn at month 24 in patients who had undetectable hepatitis B virus (HBV) DNA by PCR and normal aminotransferases during the second year of therapy.

All patients had HBV genotype B or C.

Biochemical response at months 6, 12 and 24 was 74%, 71% and 66%, respectively. HBV DNA was undetectable at months 6, 12 and 24 by hybrid capture and PCR assays in 100%, 92% and 86%; and 94%, 88% and 74% patients, respectively.

The cumulative rates of genotypic resistance (GR) after 1 and 2 years were 15% and 25%, respectively.

Four (44%) patients with GR experienced a hepatitis flare.

The probability of clinical and virological relapse 6, 12, and 18 months after treatment withdrawal were 12% and 30%, 18% and 50%, and 30% and 50%, respectively.

Reinstitution of lamivudine resulted in prompt virological and biochemical responses.



The authors conclude, 揙ur study demonstrates that a sustained response can be achieved after a 2-year course of lamivudine in a subset of patients with e-CHB.?/span>

zasxz

研究拉米的持续应答。50名广东人，大三阳，用拉米治疗两年后停药。病人基因B.C。6，12，24月内的生化应答为 74%, 71% 和 66%。100%, 92% 和 86%;和 94%, 88% 和 74%的病人中用杂交捕获和PCR化验得出HBV DNA 都测不到。
累积基因耐药率在1年和2年内为15% 和25%。
44%的基因突变病人发生肝衰竭。
临床和生化复发率在 6, 12,  18 月内是 12% ， 30%, 18% 和 50%, and 30% ，50%
重新采用拉米后产生病毒与生化应答。
结论，少数病人可以2年治疗后产生应答。

[此贴子已经被作者于2004-9-22 19:40:52编辑过]