Efficacy of Initial Telbivudine Treatment on HBeAg Positive Chronic Hepatitis B and Its Predictive Elements_West China Medical Journal

Authors：

BI Hongxia , ZHAO Qian ,  LEI Xuezhong , LEI Bingjun.

Center of Infections Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LEI Xuezhong, Email: doctorbi619@163.com

Keywords：

乙型肝炎; 预测价值; 替比夫定; 乙肝e抗原

DOI：

10.7507/1002-0179.20130124

Video：

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目的　探讨替比夫定治疗乙肝e抗原（HBeAg）阳性慢性乙型肝炎（CHB）患者72周的疗效及预测因素的分析。方法　选择2007年9月－2012年9月符合入选标准的82例CHB患者接受替比夫定治疗72周，于治疗前基线、治疗后每3个月查丙氨酸氨基转移酶（ALT）、乙肝病毒DNA（HBV DNA）、乙肝病毒血清标志物，观察治疗期间累计生化学应答率、完全病毒学应答率(CVR)、HBeAg血清学转换率（SR）及耐药率，分析基线ALT水平[分为＜5 ULN（正常值检测下限）组及≥5 ULN组]、HBV DNA水平（分为＜107 copies/mL组及≥107 copies/mL组）、24周HBV DNA水平（＜3 log 10 copies/mL组及≥3 log 10 copies/mL组），预测72周CVR及SR。结果　172周累计生化学应答率、CVR、SR、耐药率分别为86.6%、81.7%、42.7%、18.2%；2基线ALT≥5 ULN对72周SR有预测价值（χ2=5.651，P=0.017），HBV DNA＜107 copies/mL对CVR有预测价值（χ2=7.083，P=0.008）；324周HBV DNA＜103 copies/mL对72周CVR及SR均有预测价值（χ2=27.339，5.131；P=0.000，0.023）。结论　替比夫定初治HBeAg阳性CHB患者疗效及安全性好，治疗24周HBV DNA＜103 copies/mL是72周疗效的最佳预测指标。

Citation： BI Hongxia,ZHAO Qian,LEI Xuezhong,LEI Bingjun.. Efficacy of Initial Telbivudine Treatment on HBeAg Positive Chronic Hepatitis B and Its Predictive Elements. West China Medical Journal, 2013, 28(3): 391-394. doi: 10.7507/1002-0179.20130124 Copy

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12.	Yuen MF, Fong DY, Wong DK, et al. Hepatitis B virus DNA lecels at week 4 of lamivudine treatment predict the 5-year ideal response[J]. Hepatology, 2007, 46(6): 1695-1703.
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1. 　World Health Organization: The World Health Report 1997[EB/OL]. Available at http://www.who.int/whr/1997/en/index.html.
2. 　Mast EE, Margolis HS, Fiore AE, et al. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States:recommendations of the Advisory Committee on Immunization Practices(ACIP)part1: immunization of infants,children,and adolescents[J]. MMWR Recomm Rep, 2005, 54(RR-16): 1-31.
3. 　Lok AS. Chronic hepatitis B[J]. N Engl J Med, 2002, 346(22): 1682-1683.
4. 　中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南[J]. 中国病原生物学杂志, 2011, 6(1): 67-77.
5. 　贾继东, 侯金林, 尹有宽, 等. 替比夫定或拉米夫定抗乙型肝炎病毒的疗效预测探讨[J]. 中华肝脏病杂志, 2007, 15(5): 342-345.
6. 　Liaw YF, Gane E, Leung N, et al. 2-Year GLOBE trial results:telbivudine is superior to lamivudine in patients with chronic hepatitis B[J]. Gastroenterology, 2009, 136(2): 486-495.
7. 　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.
8. 　Duong A, Mousa SA. Current status of nucleoside antivirals in chronic hepatitis B[J]. Drugs Today (Barc), 2009, 45(10): 751-761.
9. 　Lau GK. Current treatments for patients with HBeAg-positive chronic hepatitis B virus infection: a comparison focusing on HBeAg seroconversion[J]. Liver Int, 2010, 30 (4): 512-520.
10. 　Zeuzem S, Gane E, Liaw YF, et al .Baseline characteristics and early on-treatment response predict the outcomes of 2 years of telbivudine treatment of chronic hepatitis B[J]. J Hepatol, 2009, 51(1): 11-20.
11. 　白鹄, 梅存金, 胡茂平, 等. 替比夫定对HBeAg 抗原阳性慢性乙肝ALT 水平与HBeAg 血清转换关系的影响[J]. 齐齐哈尔医学院学报, 2009, 30(24): 3080-3081.
12. 　Yuen MF, Fong DY, Wong DK, et al. Hepatitis B virus DNA lecels at week 4 of lamivudine treatment predict the 5-year ideal response[J]. Hepatology, 2007, 46(6): 1695-1703.
13. 　Keefe EB, Zeuzem S, Koff RS, et al. Report of an international workshop:Roadmap for management of patients receiving oral therapy for chronic hepatitis B[J]. Clin Gastroenterol Hepatol, 2007, 5(8): 890-897.

West China Medical Journal

Efficacy of Initial Telbivudine Treatment on HBeAg Positive Chronic Hepatitis B and Its Predictive Elements

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