对恩替的困惑！

不死草

昨晚在别的版里看到了一个荣誉会员对恩替这样的评价：

一.恩替，很不容易变异。但增加肝硬化和肝癌的可能性，肝硬化进程加快。

二.战友疑问“只听说恩替卡韦减缓或者部分逆转肝硬化，降低肝癌发生率，没有听说二楼的意见，请二楼给点科普资料给大家读读。
恩替卡韦耐药后，可以服用阿德福韦酯或是替诺福韦。 ... ”
他的回答：
科普资料没有。
吃恩替，病毒会更加深入到肝细胞内，和肝细胞整合。
1、更加不容易彻底转阴。
2、加快肝硬化进程。
3、肝癌概率提高。
所以，干扰素是第一选择，拉米促病毒整合的力量小，所以拉米比恩替好。

三.恩替，我告诉大家的是真的：

1、恩替抗病毒能力比拉米强。
2、恩替几乎不会变异。
3、恩替更加容易肝硬化肝癌。
4、抗病毒首选是干扰素，第二拉米。

以上三个是他战友的回答，对恩替的评价，因为他是荣誉会员，他的评价对别人还是有点影响的！
如果恩替真是这样，那服用岂不是很危险，特别是硬化的战友，那相当于间接自杀了！

有老师专家能找点文献资料什么的解释一下恩替真是如他所说吗？

無國界

   我用NT的
肝硬化好像恶化了

liver411

毫无根据。

这些都是恩替治疗中试药总结的文献，没有一个有这个问题。

Articles on Entecavir (Baraclude)

Entecavir (ETV) Therapy in Chronic Hepatitis B Patients Previously Treated with Adefovir (ADV) with Incomplete Response On-Treatment or Relapse Off-Treatment
6/05/09

Long-Term Histological Improvement with Entecavir (ETV) Therapy in Patients with Chronic Hepatitis B (CHB) from Japanese and Worldwide Development Programs
6/05/09

Entecavir Maintains a High Genetic Barrier to HBV Resistance Through 6 Years in Naïve Patients
6/05/09

Regression of Fibrosis/Cirrhosis with Long-Term Entecavir Therapy in Chronic Hepatitis B (CHB) Patients with Baseline Bridging Fibrosis or Cirrhosis: Results from Studies ETV-022, -027 and -901
6/05/09

Should Entecavir (Baraclude) and Tenofovir (Viread) Be First-line Treatment for Chronic Hepatitis B?
6/05/09

Chronic Hepatitis B Patients Who Had Incomplete Response or Relapse on Adefovir (Hepsera) Respond Well to Entecavir (Baraclude)
5/01/09

Entecavir (Baraclude) Produces Greater Early HBV DNA Suppression than Adefovir (Hepsera) in Chronic Hepatitis B Patients
3/17/09

HBV Relapse after 48 Weeks of Entecavir (Baraclude) Suggests Need for Continuous Therapy
2/24/2009

Japanese Study Finds Entecavir (Baraclude) Is Effective and Well-tolerated in Treatment-naive Chronic Hepatitis B Patients
2/10/2009

Rescue Therapy with Entecavir (Baraclude) plus Tenofovir (Viread) Is Safe and Effective for Cirrhotic Hepatitis B Patients with Prior Treatment Failures
11/21/2008

Long-term Entecavir (Baraclude) Reverses Liver Fibrosis in HBeAg Positive and HBeAg Negative Chronic Hepatitis B Patients
11/05/2008

Three Years of Entecavir (ETV) Re-treatment of HBeAg(-) ETV Patients Who Previously Discontinued Treatment: Results from Study ETV-901
11/05/2008

Five Years of Continuous Entecavir for Nucleoside-naïve HBeAg(+) Chronic Hepatitis B: Results from Studies ETV-022/-901
11/05/2008

Cost Effectiveness Simulation Analysis of Tenofovir Disoproxil Fumarate (TDF), Lamivudine (LAM), Adefovir Dipivoxil (ADV) and Entecavir (ETV) in HBeAg Negative Patients with Chronic Hepatitis B (CHB) in the USA
11/05/2008

Long-term Entecavir Therapy Results in Reversal of Fibrosis/Cirrhosis and Continued Histologic Improvement in Patients with HBeAg(+) and (-) Chronic Hepatitis B: Results from Studies ETV-022, -027 and -901
11/05/2008

Histologic Assessment of Long-term Entecavir Treatment in Chronic Hepatitis B Patients
11/05/2008

Evaluation of Long-term Entecavir Treatment in Stable Chronic Hepatitis B Patients Switched from Lamivudine Therapy
11/05/2008

UK Health Agency Recommends Approval of Entecavir (Baraclude) for Treatment of Eligible Patients with Chronic Hepatitis B
6/25/08

Three Years of Continuous Treatment with Entecavir Results in High Proportions of Chinese Nucleoside-Naïve Patients with Undetectable HBV DNA: Results from Studies ETV-023 and -050
5/09/08


Tenofovir May Be More Effective and Less Expensive than Lamivudine (Epivir-HBV) and Adefovir (Hepsera) as First-line Treatment for HBeAg- Chronic Hepatitis B
5/09/08

Lamivudine (Epivir-HBV) plus Adefovir (Hepsera) Is an Effective Regimen for Lamivudine-resistant HBV Patients Who Develop Resistance to Entecavir (Baraclude)
5/09/08

Entecavir (Baraclude) Produces Greater Decrease in HBV DNA than Adefovir (Hepsera) in Treatment-naive HBeAg+ Patients: 96 Week Data from EARLY Study
5/09/08

Three Years of Continuous Entecavir (Baraclude) in Chinese Patients with Prior Lamivudine (Epivir-HBV) Failure: Studies ETV-056 and ETV-050
5/09/08

Entecavir (Baraclude) Treatment in Japanese Nucleoside-naive Chronic Hepatitis B Patients
5/09/08

liver411

这些是恩替对肝硬化治疗效益的部分文献:

#
Entecavir (Baraclude) - HBV
Regression of Fibrosis/Cirrhosis with Long-Term Entecavir Therapy in Chronic Hepatitis B (CHB) Patients with Baseline Bridging Fibrosis or Cirrhosis: ...
www.hivandhepatitis.com/hep_b/news/entecavir.html - Cached
#
Long-term Entecavir (Baraclude) Reverses Liver Fibrosis in HBeAg ...
Nov 4, 2008 ... Long-term entecavir therapy results in reversal of fibrosis/cirrhosis and continued histologic improvement in patients with HBeAg(+) and ...
www.hivandhepatitis.com/2008icr/aasld/docs/110408_b.html - Cached
#
Japanese Study Finds Entecavir (Baraclude) Is Effective and Well ...
Feb 10, 2009 ... 81% of patients in the 0.1 mg entecavir arm and 68% in the 0.5 mg arm achieved ... HBV Articles by Topic. HBV Liver Issues Cirrhosis ...
www.hivandhepatitis.com/hep_b/news/2009/021009_a.html - Cached
#
UK Health Agency Recommends Approval of Entecavir (Baraclude) for ...
Jun 25, 2008 ... Entecavir is a potent anti-viral treatment for chronic Hepatitis B that ... “Chronic Hepatitis B is a leading cause of liver cirrhosis and ...
www.hivandhepatitis.com/hep_b/news/.../062408_baraclude.html - Cached
#
Should Entecavir (Baraclude) and Tenofovir (Viread) Be First-line ...
Jun 4, 2009 ... Should Entecavir (Baraclude) and Tenofovir (Viread) Be First-line Treatment for ... include those with liver cirrhosis, HIV-HBV coinfection, ...
www.hivandhepatitis.com/2009icr/ddw/docs/060509_c.html - Cached
#
Response to PegIntron/ribavirin Leads to Stabilization of Fibrosis ...
“Entecavir treatment was effective in patients with chronic hepatitis B and advanced liver fibrosis/cirrhosis,” the researchers concluded. ...
www.hivandhepatitis.com/2007icr/easl/docs/050107_e.html - Cached
#
Entecavir (Baraclude) Has Reduced Activity in Hepatitis B Patients ...
Jul 7, 2009 ... Resistance to entecavir was rare, however, among individuals who were not previously .... HBV Articles by Topic. HBV Liver Issues Cirrhosis ...
www.hivandhepatitis.com/hep_b/news/2009/070709_a.html - Cached
#
Another Report of Drug-resistant HIV in a Patient Treated with ...
Apr 11, 2008 ... Entecavir had previously been recommended for use by HIV-HBV ... in 1986 showed only minor liver damage, he developed cirrhosis by 2002. ...
www.hivandhepatitis.com/hiv_hbv_co_inf/2008/041108_a.html - Cached
#
Tenofovir (Viread) Effective Against Entecavir-resistant Hepatitis ...
Aug 26, 2008 ... Entecavir resistance has previously not been reported in nucleoside-naive patients, ... HBV Articles by Topic. HBV Liver Issues Cirrhosis ...
www.hivandhepatitis.com/hep_b/news/2008/082608_a.html - Cached

liver_for_life

任何药物，需要经过临床检验。记得拉米才出来时，大家也没觉得有什么不好，但过了两年，发现其容易变异。
恩替出来时间较短，到底有什么副作用，很难说。
还好我用了阿德，效果还好。

求医★问药

:L :L

liver411

“ETV 增加肝硬化和肝癌的可能性，肝硬化进程加快” 这话要有根据的。

liver411

”吃恩替，病毒会更加深入到肝细胞内，和肝细胞整合” 这也要从病毒学上得到解释。

不死草

还是411老师厉害，这样的文献都看过，称得上真正的专家，只是英文文献用我那点可怜的英文水平简直是看天书，只好求助在线翻译了！

国界，我看过你的帖子，你那样的情况，个人感觉因素很多，不一定是恩替的作用~

無國界

我现在很迷茫
不知道如何是好
病毒继续在抗