2年拉米夫定治疗HBeAg阴性慢性乙型肝炎的持续应答

tonychant

文题：Sustained response after a 2-year course of lamivudine treatment of hepatitis B e antigen-negative chronic hepatitis B. 作者：Fung SK, Wong F, Hussain M, Lok AS 杂志全名：Journal of Viral Hepatitis 年份，卷（期）: 起止页码：2004 ;11(5):432-8 PMID: 15357648 英文摘要： Lamivudine has demonstrated efficacy for the treatment of hepatitis B e 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. We report our treatment experience 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 Treatment was withdrawn at month 24 in patients who had undetectable hepatitis B virus (HBV) DNA by PCR and normal aminotransferases during the second year of therapy.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. Our study demonstrates that a sustained response can be achieved after a 2-year course of lamivudine in a subset of patients with e-CHB. 中文译文： 2年拉米夫定治疗HBeAg阴性慢性乙型肝炎的持续应答 [摘要] 背景与目的; 拉米夫定可有效的治疗HBeAg阴性慢性乙型肝炎(e-CHB )，但在治疗1年后停药复发率高而长期治疗又增长了耐药风险。 方法; 我们报道50例华裔加拿大e-CHB患者的治疗经验，全部患者接受2年的拉米夫定治疗,在第二年期间患者使用PCR方法HBV DNA水平无法检测及转氨酶正常时在24个月停药. 结果; 全部患者HBV基因型为B或C型，生化应答在6，12，24个月分别为74%, 71% 与66%,在6，12，24个月使用杂交捕获试验与PCR方法检测,HBV DNA水平无法检测率分别为100%, 92% ，86%与94%, 88% ，74%.在1年与2年后累积基因型抵抗（GR）率分别为15%与25%，4例（44%）GR患者有肝炎发作，在治疗停止后6，12，18个月临床与病毒学复发可能性分别为12% 与30%, 18% 与 50%,30% 与 50%，再次拉米夫定治疗后可有迅速的病毒学与生化应答. 结论; 我们的研究证实HBeAg阴性慢性乙型肝炎患者2年拉米夫定治疗可获得持续的应答。

大排长

谢谢，小三阳对拉米应有信心。