Observations on dynamic changes of high level hepatitis B virus during sequential therapy of chronic hepatitis B with IFN α-1b and lamivudine.
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摘要: 目的观察干扰素α-1b(IFNα-1b)和拉米夫定序贯治疗对慢性乙型肝炎的高水平复制HBV清除动力学的影响。方法76例HBeAg阳性且HBV DNA>1×107copies/ml慢性乙型肝炎患者随机分为治疗组和对照组。治疗组40例,先用拉米夫定治疗4周,再加用IFNα-1b治疗8周,然后单用IFNα-1b治疗16周,对照组36例单用IFNα-1b治疗24周。分别于治疗前后定期检测肝功能、血常规、乙肝标志物及HBV DNA。结果治疗结束时,治疗组的ALT复常率、HBV DNA阴转率、HBeAg阴转率及抗-HBe阳转率均明显高于对照组(P<0.05,P<0.01),治疗组有效率(72.5%)明显高于对照组(50.0%)(P<0.05)。治疗期间两组的副反应无明显的差异(P>0.05)。随访6个月治疗组的上述指标仍高于对照组(P<0.05),仅两组间的抗-HBe阳转率差异无显著性(P>0.05)。结论IFNα-1b和拉米夫定序贯治疗对HBV高水平复制的慢性乙型肝炎有较好的效果,优于单用IFNα-1b治疗。Abstract: Objective To observe the efficacy of sequential therapy with interferon α-1b (IFNα-1b) and lamivudine on treatment of chronic hepatitis B with high level HBV DNA.Methods 76 patients with HBeAg positive and HBV DNA>1×107 copies/ml were randomly divided into 2 groups.The treatment group (n=40) were treated with Lamivudine for 4 weeks, lamivudine plus IFN α1b for 8 weeks and IFN α-1b alone for 16 weeks.The control group (n=36) was given IFN α-1b alone for 24 weeks.Before and after treatment, hepatic function, blood test, viral markers and HBV DNA of the 2 groups were detected respectively.Results At the end of treatment, the rate of normal ALT, the negative rate of HBV DNA and HBeAg, and the positive rate of HBeAb were higher in treatment group than control group (P<0.05;P<0.01) .The efficacy rate of the treatment group (72.5%) was higher than that of the control group (50.0%) .There was no significant different in adverse effects between the 2 groups (P>0.05) .After 6 months follow up, those were still higher in the treatment group than the control group (P<0.05) , but there was no obvious significant different in the positive rate of HBeAb between the 2 groups (P>0.05) .Conclusion Sequential therapy with IFN α-1b and lamivudine has good therapeutic efficacy in treatment of chronic hepatitis B with high level HBV DNA and is superior to IFN α-1b alone.
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Key words:
- interferon α-1b /
- lamivudine /
- hepatitis B virus /
- sequential therapy
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[1] 中华医学会.病毒性肝炎防治方案[J].中华肝脏病杂志, 2000, 8∶324~329. [2]Marques AR, Lau DT, McKenzie R, et al.Combination therapy withFanciclovir and IFN-alpha for treatment of Chronic Hepatitis B[J].J Infect Dis, 1998, 178 (5) ∶1483~1487. [3]Nair S, perrillo RP.Serum alanine aminotransferase flares during in-terferon treatment of chronic hepatitis B:is sustained clearance ofHBV DNAdependent on levels of pretreatment viremia[J]?Hepatol-ogy, 2001, 34 (5) ∶1021~1026. [4]Yuen MF, Hui CK, Cheng CC, et al.Long termfollow-up of inter-feron alpha treatment in Chinese patients with chronic hepatitis B in-fection:the effect on hepatitis B e antigen seroconversion and the de-velopment of cirrhosis-related complications[J].Hepatology, 2001, 34 (1) ∶139-145. [5]Lawrence S, Dominique I, Fabien I, et al.Sequential treatment withLamivadine and interferon monotherapies in patients with chronichepatitis B not responding to Interferon alone:results of a pilotstudy[J].Hepatology, 2001, 34 (3) ∶573. [6]舒丹, 杨大国, 高志良, 等.干扰素α联合拉米夫定治疗慢性乙型肝炎的短期疗效及其影响因素[J].中华传染病杂志, 2003, 21 (2) ∶118~121. [7]李耀才, 陈小萍, 易聪垣.拉米夫定与干扰素序贯治疗慢性乙型肝炎疗效观察[J].中华传染病杂志, 2006, 24 (1) ∶58~59. [8]Carolina B, Amalia P, Grahams O, et al.Lamivudine Treatment canovercome Cytotoxic T-cell Hyporesponsiveness in chronic hepatitisB:new perspectives for immane therapy[J].Hepatology, 2001, 33 (4) ∶963.
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