乙型肝炎――治疗――联合治疗

淡淡然

乙型肝炎――治疗――联合治疗
土耳其的研究者报道了第一例针对一位具有慢性乙肝的女患者联合使用重组乙肝疫苗和拉米夫定治疗18个月的治疗效果。
联合治疗的最初目的是评价重组抗乙肝疫苗是否能够阻止乙型肝炎病毒的变异和其是否能够维持HBeAg抗原的血清学转换（血清HBV-DNA检测阴性）。
本例数据表明联合抗乙肝疫苗和拉米夫定，且延长治疗时间不能清除病毒DNA，也不能够阻止抵抗型乙肝病毒的产生。
尽管联合治疗不能够达到治疗学终点，但其仅仅涉及一例且是唯一的一例病人。
作者最后得出结论指出：联合乙肝疫苗和拉米夫定来治疗乙型肝炎需要进一步的随机对照研究来阐明其可行性。
Combination Treatment of Recombinant HBV Vaccine Plus Lamivudine Failed to Produce Undetectable HBV DNA and Did Not Prevent HBV Resistance in a Patient with Chronic HBV
Turkish researchers report the first case of a woman having chronic hepatitis B treated with a combination therapy of recombinant hepatitis B vaccine and lamivudine (Epivir-HBV) for 18 months.
The primary objectives of the combination therapy were to assess whether the concomitant anti-hepatitis B virus (HBV) vaccination might prevent the emergence of a mutant HBV and lead to sustained hepatitis B e antigen seroconversion with undetectable serum HBV DNA.
The data from the case demonstrated that combination of anti-HBV vaccine and lamivudine did not eliminate viral DNA despite prolonged treatment and did not have any effect on preventing resistant-type HBV.
Although the combined therapy failed to reach the therapeutic endpoints, it concerned a single and unique patient.
The authors conclude, Hepatitis B vaccine and lamivudine for HBV treatment should be further investigated in randomized controlled trials.?/span>
Division of Hepatology, Department of Internal Medicine, Dicle University School of Medicine, Diyarbaki, Turkey.
05/12/04
Reference
K Yalcin and others.Late failure of combined recombinant hepatitis B vaccine and lamivudine in treatment of a patient with chronic hepatitis B. Southern Medical Journal 97(4):407-409. April 2004.