拉米夫定治疗慢乙肝的长期疗效及安全性评价

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.