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Long-term effect and safety of Lamivudine in chronic hepatitis B virus infection
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摘要: 研究拉米夫定 （lamivudine）对慢性乙型肝炎 （慢乙肝 ）的长期疗效和安全性。 4 9例患者均用拉米夫定10 0mg/d ,疗程 1～ 2年。疗效评估包括临床症状和体征、肝功能、HBV复制的指标。治疗 3～ 6个月时 ,HBV -DNA阴转率为 87 8%～ 75 5 % ,2年时降至 4 0 9%。疗程结束时HBeAg的血清转换率为 11 8%。 6个月时ALT复常率为 79 6 %。疗程结束时ALT复常率为 5 9 1%。拉米夫定治疗 6～ 9个月后可出现YMDD变异 ,随着疗程的延长YMDD变异率升高 ,YMDD变异后病情急性发作者 ,多出现HBeAg的血清转换。拉米夫定能有效抑制HBV复制 ,迅速降低血清中HBV -DNA水平 ,提高HBeAg血清转换率 ,长期服用耐受性好 ,但疗程越长YMDD变异率越高。Abstract: To evaluate the long-term effect and safety of Lamivudine in patients with chronic hepatitis B.49 patients received lamivdine 100mg daily for one to two years.The efficacy and safety were evaluated with clinical, bio-chemical, hematological and virological parameters.After 3～6 months treatment, serum levels of HBV-DNA decreased to undetectable levels in 87 8% to 75 5% of patients and 40 9% by the end of treatment The HBeAg seroconversion rates was 11 8% at the end of treatment, .ALT normalization rate was 79 6% at 6 months and 59 1% at 24 months.After 9 months treatment, YMDD mutants were detected, the risk of the mutation increases with time.However, development of the YMDD did not preclude serocon-version.After the emergence of the YMDD variants, the patients experienced acute exacerbation followed by recovery and HBeAg seroconversion.Lamivudine suppresses serum viral replication rapidly, causing reductions in serum HBV-DNA and well tolerated.However, YMDD mutants were increased with prolonged treatment.
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Key words:
- Hepatitis B /
- Lamivdine /
- long-term effect
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