Lamivudine Maintenance Beyond One Year After HBeAg Seroconversion Is a Major Factor for Sustained Virologic Response in HBeAg-Positive Chronic Hepatitis B
Lamivudine Maintenance Beyond One Year After HBeAg Seroconversion Is a Major Factor for Sustained Virologic Response in HBeAg-Positive Chronic Hepatitis B
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DOI：
10.1002/hep.23323
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发表时间：
2010-02-01
期刊：
影响因子：
13.5
通讯作者：
Han, Kwang-Hyub
中科院分区：
文献类型：
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作者：
Lee, Hyun Woong;Lee, Heon Ju;Han, Kwang-Hyub
拉米夫定单药治疗成功后病毒学应答的持久性是可变的，问题仍然是病毒学应答是否可以在延长的随访期内维持。本研究的目的是探讨拉米夫定单药治疗HBeAg阳性慢性B型肝炎（CH B）后的治疗持久性、HBeAg清除或血清转换后额外治疗的最佳持续时间以及持续病毒学应答（SVR）的决定因素。从1999年1月至2004年8月，178名韩国HBeAg阳性CH B患者接受拉米夫定治疗，并获得完全缓解，定义为血清HBeAg和B型肝炎病毒DNA的丢失，以及丙氨酸氨基转移酶正常化。拉米夫定单药治疗的平均持续时间为26个月（范围，12-77）。138例患者（77.5%）维持了SVR。比较了138例SVR患者和40例应答不持续的患者的宿主和病毒因素。累积复发率从1年的15.9%增加到5年的30.2%，停用拉米夫定后复发的平均时间为12个月（范围，7-42）。大多数复发发生在停用拉米夫定后2年内（33/40，82.5%）。在多变量分析中，年龄
The reported durability of virologic response after successful lamivudine monotherapy is variable, and the question remains as to whether virologic responses can be maintained over an extended follow-up period. The aim of this study was to investigate posttreatment durability, the optimal duration of additional treatment after HBeAg clearance or seroconversion, and determinants for sustained virologic response (SVR) following lamivudine monotherapy in patients with HBeAg-positive chronic hepatitis B (CHB). From January 1999 to August 2004, 178 Korean patients with HBeAg-positive CHB were treated with lamivudine and achieved complete responses, defined as a loss of serum HBeAg and hepatitis B virus DNA, and alanine aminotransferase normalization. The mean duration of lamivudine monotherapy was 26 months (range, 12-77). SVR was maintained in 138 patients (77.5%). Host and viral factors were compared between 138 patients with SVR and 40 patients whose response was not sustained. The cumulative relapse rates increased from 15.9% at I year to 30.2% at 5 years, with a mean time to relapse after cessation of lamivudine of 12 months (range, 7-42). Most relapses occurred within 2 years after discontinuation of lamivudine (33/40, 82.5%). On multivariate analysis, age