比较拉米夫定+干扰素-a2a与拉米夫定+干扰素-a2b治疗少儿慢性乙型肝炎感染的抗病毒疗效

tonychant

Comparison of antiviral effect of lamivudine with interferon-alpha2a versus -alpha2b in children with chronic hepatitis B infection. 作者：Ozgenc F, Dikici B, Targan S, Doganci T, Akman S, Aydogdu S, Yagci RV. 杂志全名： Antiviral therapy. 年份，卷（期）: 起止页码： 2004 ;9(1):23-6. PMID： 15040533 英文摘要： AIM: To compare additive efficacy of combination therapy including interferon (IFN)-alpha2a+lamivudine (3TC) to IFN-alpha2b+3TC in children with chronic hepatitis B virus (HBV) infection. MATERIAL AND METHODS: Chronic hepatitis B infection was determined by presence of HBsAg, HBeAg and HBV DNA in serum screened at 3 months intervals for at least 1 year, serum alanine transaminase (ALT) levels more than 1.5-times the upper normal limit and chronic hepatitis with histological activity index (HAI) more than 6 by liver biopsy. Sixty-three children with chronic hepatitis B infection were treated randomly with thrice-weekly subcutaneous injections of 5 MU/m2 recombinant IFN-alpha2a (n=29) or recombinant IFN-alpha2b (n=34) with the same dose, intervals for 6 months. Patients also received 3TC (4 mg/kg/day, max 100 mg/day) orally daily combined with IFN and continued for 12 months. End of therapy response was defined as ALT normalization, HBV DNA clearance and HBe/anti-HBe seroconversion. Breakthrough infection was determined as re-emergence of HBV DNA in serum after its clearance. Response rate, incidence of side effects and breakthrough infection were compared between IFN-alpha2a+3TC- and IFN-alpha2b+3TC-treated patients. RESULTS: Response rate was 44.8% (n=13) with IFN-alpha2a+3TC and 47.1% (n=16) with IFN-alpha2b+3TC (P=1.0). No significant difference was found in respect to the DNA clearance (P=0.32), anti-HBe (P=1.0), anti-HBs (P=0.09) seroconversion and response rates (P=1.0) between the groups. Breakthrough infection was detected in 1 (3.4%) case on IFN-alpha2a and none of the cases on IFN-alpha2b (P=0.46). All of the patients experienced flu-like symptoms, malaise and fatigue; however, side effect interfering with therapy was not encountered. CONCLUSION: No significant difference was found in response rates achieved by combination therapies based on IFN-alpha2a and IFN-alpha2b. Clinical efficacy of 3TC and two different IFN subtypes was found similar. 摘要] 目的; 比较拉米夫定+干扰素-a2a与拉米夫定+干扰素-a2b治疗少儿慢性乙型肝炎感染的抗病毒疗效. 病人与方法; 慢性乙型肝炎感染被定义为至少1年每间隔三个月血清检测HBsAg，HBeAg与HBV DNA 阳性，ALT水平>1.5×ULN,肝活检组织学HAI>6。63例少儿慢性乙型肝炎感染患者随机接受3次/周的皮下注射5 MU/m2 干扰素-a2a(n=29)和5 MU/m2干扰素-a2b(n=34)治疗,间隔6个月后,患者再接受拉米夫定(4 mg/kg/天, 最大 100 mg/天)1次/天联合干扰素治疗持续12个月。治疗完全应答定义为ALT正常,HBV DNA清除和HBeAg/抗HBe血清转换。感染突破定义为在HBV DNA清除后血清中再次出现HBV DNA。拉米夫定+干扰素-a2a与拉米夫定+干扰素-a2b治疗组间的应答率,负作用和感染突破率被比较。 结果; 拉米夫定+干扰素-a2a组应答率为44.8% (n=13),拉米夫定+干扰素-a2b组应答率为 47.1% (n=16)(P=1.0)。两组间HBV DNA清除(P=0.32), 抗HBe(P=1.0)和抗HBs(P=0.09)血清转换与应答率(P=1.0)无显著差异。拉米夫定+干扰素-a2a组1例(3.4%)发生感染突破而拉米夫定+干扰素-a2b组无感染突破发生(P=0.46)。全部患者均有流感样症状,不适和疲劳, 然而,无影响治疗的负作用发生。 结论; 基于干扰素-a2a与干扰素-a2b的联合治疗间应答率未见明显差异,拉米夫定+干扰素-a2a与拉米夫定+干扰素-a2b治疗两组间临床疗效是相似的。

jackwen

好。现在还用序冠疗法吗？