The addition of mycophenolate mofetil for suppressing hepatitis B virus replication in liver recipients who developed lamivudine resistance - No beneficial effect
The addition of mycophenolate mofetil for suppressing hepatitis B virus replication in liver recipients who developed lamivudine resistance - No beneficial effect
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DOI：
10.1097/00007890-200101150-00026
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发表时间：
2001-01-15
期刊：
影响因子：
6.2
通讯作者：
Tur-Kaspa, R
中科院分区：
文献类型：
--
作者：
Ben-Ari, Z;Zemel, R;Tur-Kaspa, R
背景。吗替麦考酚酯用作肝移植受者的免疫抑制剂。其活性化合物霉酚酸还可以抑制 Epstein-Barr 病毒和人类免疫缺陷病毒的复制。基于一项表明霉酚酸酯对培养的受感染人肝细胞中乙型肝炎病毒 (HBV) 复制的有效性的研究，我们检查了霉酚酸酯在抑制拉米夫定耐药同种异体肝移植受者复发性 HBV 感染中 HBV 复制的功效。研究人群包括四名同种异体肝脏移植受者（三名男性，一名女性），中位年龄 51 岁（范围 41-57 岁），患有复发性 HBV 感染，且被证明对拉米夫定耐药。所有患者均接受标准维持性免疫抑制治疗。治疗前中位血清丙氨酸转氨酶水平为 75 μL（范围 39-182 μL），HBV DNA 水平（定量斑点印迹）为 70 pg/ml（范围：10-5000 pg/ml）。吗替麦考酚酯，1.0 g 口服每日两次，持续 8 周，同时减少皮质类固醇和环孢素的维持剂量。结果。服用吗替麦考酚酯后，2 名患者的血清丙氨酸转氨酶水平升高，1 名患者的血清丙氨酸氨基转移酶水平没有变化，1 名患者的血清丙氨酸氨基转移酶水平下降。三名患者的血清 HBV DNA 水平升高，只有一名患者的血清 HBV DNA 水平下降（不显着）。两名患者主诉腹痛和恶心。结论。吗替麦考酚酯的使用剂量不能有效抑制肝移植后的 HBV 复制。
Background. Mycophenolate mofetil is used as an immunosuppressive agent in liver transplant recipients. Its active compound, mycophenolic acid, also inhibits the replication of Epstein-Barr virus and human immunodeficiency virus. Based on a study indicating the effectiveness of mycophenolate mofetil on hepatitis B virus (HBV) replication in infected human hepatocyte cells in culture, we examined the efficacy of mycophenolate mofetil in suppressing HBV replication in lamivudine-resistant liver allograft recipients with recurrent HBV infection.Method. The study population included four liver allograft recipients (three males, one female), median age 51 years (range 41-57 years), with recurrent HBV infection who proved to be resistant to lamivudine. All received standard maintenance immunosuppression therapy. Median pretreatment serum alanine aminotransferase level was 75 muL (range 39-182 muL) and HBV DNA level (quantitative dot blot), 70 pg/ml (range: 10-5000 pg/ml). Mycophenolate mofetil, 1.0 g p.o. twice daily, mas administered for 8 weeks, concomitant with a reduction in the maintenance corticosteroid and cyclosporine doses.Results. After mycophenolate mofetil was administered, the serum alanine aminotransferase level increased in two patients, did not change in one, and decreased in one. Serum HBV DNA levels increased in three patients and decreased (nonsignficantly) in only one patient. Two patients complained of abdominal pain and nausea.Conclusions. Mycophenolate mofetil at the dosage used is not effective in suppressing HBV replication after liver transplantation.