Effective Treatment for Patients with Viral Relapse after Adefovir Withdrawl by the Combination of Lamivudine plus Adefovir_West China Medical Journal

Authors：

LIU Jie , QI Jun

Department of Infectious Diseases, First People’s Hospital of Liangshan, Xichang, Sichuan 615000, P. R. China;

Corresponding?author：

Keywords：

慢性乙型肝炎; 病毒學反彈; 阿德福韋酯; 拉米夫定; 聯合治療

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的　比較拉米夫定+阿德福韋酯聯合治療與阿德福韋酯單藥治療對阿德福韋酯停藥后出現病毒學反彈而無基因型耐藥變異患者的療效及安全性。方法　回顧研究2007年1月－2012年1月在傳染科門診就診的67例阿德福韋酯治療獲得病毒學應答但停藥后出現病毒學反彈的e抗原陽性慢性乙型肝炎患者，分別給予拉米夫定+阿德福韋酯聯合治療（聯合組，n=35）和阿德福韋酯單藥治療（單藥組，n=32）。結果　治療1年后，聯合組（32例，85.7%）較單藥組（21例，65.6%）有更多的患者重新獲得了丙氨酸轉氨酶復常（P=0.009），聯合組34例（97.1%）乙型肝炎病毒DNA陰轉，單藥組22例（68.8%）陰轉，兩組差異有統計學意義（P=0.002）；在血清學轉換方面，聯合組和單藥組分別有4例（11.4%）和1例（3.1%）患者獲得了e抗原的血清學轉換。在治療中所有患者均未發生任何嚴重不良反應。結論　阿德福韋酯停藥后出現病毒學反彈，選擇拉米夫定與阿德福韋酯聯合治療可使患者重新獲得較好的生化學和病毒學應答。

Citation： LIU Jie,QI Jun. Effective Treatment for Patients with Viral Relapse after Adefovir Withdrawl by the Combination of Lamivudine plus Adefovir. West China Medical Journal, 2012, 27(8): 1143-1145. doi: Copy

1.	Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures[J]. J Viral Hepat, 2004, 11(2): 97-107.
2.	Song BC, Suh DJ, Lee HC, et al. Hepatitis B e antigen seroconversion after lamivudine therapy is not durable in patients with chronic hepatitis B in Korea[J]. Hepatology, 2000, 32(4 Pt 1): 803-806.
3.	Dienstag JL, Cianciara J, Karayalcin S, et al. Durability of serologic response after lamivudine treatment of chronic hepatitis B[J]. Hepatology, 2003, 37(4): 748-755.
4.	Ito K, Tanaka Y, Orito E, et al. Predicting relapse after cessation of Lamivudine monotherapy for chronic hepatitis B virus infection[J]. Clin Infect Dis, 2004, 38(4): 490-495.
5.	中華醫學會肝病學分會，中華醫學會感染病學分會. 慢性乙型肝炎防治指南[J]. 中華肝臟病雜志, 2006, 9(1): 8-18.
6.	European Association for the Study of the Liver. EASL Clinical Practice Guidelines: management of chronic hepatitis B[J]. J Hepatol, 2009, 50(2): 227-242.
7.	Delaney WE 4th. Progress in the treatment of chronic hepatitis B: long-term experience with adefovir dipivoxil[J]. J Antimicrob Chemother, 2007, 59(5): 827-832.
8.	Lim SG, Cheng Y, Guindon S, et al. Viral quasi-species evolution during hepatitis Be antigen seroconversion[J]. Gastroenterology, 2007, 133(3): 951-958.
9.	Lok AS, Zoulim F, Locarnini S, et al. Antiviral drug-resistant HBV: standardization of nomenclature and assays and recommendations for management[J]. Hepatology, 2007, 46(1): 254-265.
10.	Sanchez MJ, Buti M, Homs M, et al. Successful use of entecavir for a severe case of reactivation of hepatitis B virus following polychemotherapy containing rituximab[J]. J Hepatol, 2009, 51(6): 1091-1096.
11.	白浪，楊文斌，劉麗，等. 阿德福韋酯聯合拉米夫定治療阿德福韋酯應答不佳的慢性乙型肝炎的臨床觀察[J]. 華西醫學, 2011, 26(9): 1281-1283.
12.	劉鋒，朱利紅，孔亞蘭，等.替比夫定聯合阿德福韋酯治療阿德福韋酯應答不佳的乙型肝炎病毒e抗原陽性慢性乙型肝炎患者[J]. 華西醫學, 2012, 27(1): 14-17.

1. 　Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures[J]. J Viral Hepat, 2004, 11(2): 97-107.
2. 　Song BC, Suh DJ, Lee HC, et al. Hepatitis B e antigen seroconversion after lamivudine therapy is not durable in patients with chronic hepatitis B in Korea[J]. Hepatology, 2000, 32(4 Pt 1): 803-806.
3. 　Dienstag JL, Cianciara J, Karayalcin S, et al. Durability of serologic response after lamivudine treatment of chronic hepatitis B[J]. Hepatology, 2003, 37(4): 748-755.
4. 　Ito K, Tanaka Y, Orito E, et al. Predicting relapse after cessation of Lamivudine monotherapy for chronic hepatitis B virus infection[J]. Clin Infect Dis, 2004, 38(4): 490-495.
5. 　中華醫學會肝病學分會，中華醫學會感染病學分會. 慢性乙型肝炎防治指南[J]. 中華肝臟病雜志, 2006, 9(1): 8-18.
6. 　European Association for the Study of the Liver. EASL Clinical Practice Guidelines: management of chronic hepatitis B[J]. J Hepatol, 2009, 50(2): 227-242.
7. 　Delaney WE 4th. Progress in the treatment of chronic hepatitis B: long-term experience with adefovir dipivoxil[J]. J Antimicrob Chemother, 2007, 59(5): 827-832.
8. 　Lim SG, Cheng Y, Guindon S, et al. Viral quasi-species evolution during hepatitis Be antigen seroconversion[J]. Gastroenterology, 2007, 133(3): 951-958.
9. 　Lok AS, Zoulim F, Locarnini S, et al. Antiviral drug-resistant HBV: standardization of nomenclature and assays and recommendations for management[J]. Hepatology, 2007, 46(1): 254-265.
10. 　Sanchez MJ, Buti M, Homs M, et al. Successful use of entecavir for a severe case of reactivation of hepatitis B virus following polychemotherapy containing rituximab[J]. J Hepatol, 2009, 51(6): 1091-1096.
11. 　白浪，楊文斌，劉麗，等. 阿德福韋酯聯合拉米夫定治療阿德福韋酯應答不佳的慢性乙型肝炎的臨床觀察[J]. 華西醫學, 2011, 26(9): 1281-1283.
12. 　劉鋒，朱利紅，孔亞蘭，等.替比夫定聯合阿德福韋酯治療阿德福韋酯應答不佳的乙型肝炎病毒e抗原陽性慢性乙型肝炎患者[J]. 華西醫學, 2012, 27(1): 14-17.

West China Medical Journal

Effective Treatment for Patients with Viral Relapse after Adefovir Withdrawl by the Combination of Lamivudine plus Adefovir

Abstract Full text Figures/Tables Video References Cited by

Format

Content