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- 2011-12-19
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LZ提供的例子中,有个人alt是正常的,于是用了五个月的硝唑尼特,然后撤除,使alt不正常,然后再开始用硝唑尼特的,达到了金牌的治疗效果。详细试验见下:
Methods: Case #1 is a 17-year-old male with HBeAg-positive CHB and
baseline HBV DNA level of 310,000 copies/mL, ALT 25 IU/mL, and grade
3/18 inflammation and stage 1/6 fibrosis on biopsy. He was treated with NTZ
500 mg bid through month 5, was off treatment for 3 months secondary to
elevated ALT levels, and then was treated with 500 mg/d through month
24. Case #2 is a 60-year-old male with HBeAg-positive CHB who received
lamivudine 100 mg/d for 2 years and then ADV 10 mg/d for 1 year without
response; NTZ 500 mg bidwas then added toADV10 mg/d and combination
therapy continued for two years. When NTZ was added to ADV, baseline
serum HBV DNA was 8,380,000 IU/mL and ALT was 82 IU/L.
Results: Case #1 first developed undetectable HBV DNA at month 13, negative
HBeAg at month 12, and negative HBsAg at month 21. Case #2, after
1 year of dual therapy with NTZ and ADV, had decrease in HBV DNA to
71,000 IU/ml and ALT to 61 IU/L. After 2 years of dual therapy, HBV DNA
was undetectable, ALT was 19 IU/L, and HBeAg and HBsAg were negative.
Case #2 also developed antibody to HBsAg (anti-HBs), confirming that he
underwent HBsAg seroconversion.
Conclusion: These two case reports provide further clinical evidence of
antiviral activity of NTZ in patients with CHB and suggest that NTZ may
achieve higher rates of HBeAg and HBsAg loss and seroconversion than
current oral antiviral agents. Randomized, controlled trials are needed to
confirm these results in a large number of subjects with CHB, and these
studies have been initiated. |
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