Tenofovir disoproxil fumarate therapy for chronic hepatitis B in human immunodeficiency virus/hepatitis B virus-coinfected individuals for whom interferon-α and lamivudine therapy have failed
Tenofovir disoproxil fumarate therapy for chronic hepatitis B in human immunodeficiency virus/hepatitis B virus-coinfected individuals for whom interferon-α and lamivudine therapy have failed
复制标题
DOI：
10.1086/345770
复制
发表时间：
2002-12-15
影响因子：
6.4
通讯作者：
Tebas, P
中科院分区：
文献类型：
--
作者：
Ristig, MB;Crippin, J;Tebas, P
相当大比例的人类免疫缺陷病毒(HIV)感染者同时感染了乙肝病毒(HBV)。目前治疗慢性乙型肝炎的有效方法(干扰素[干扰素]-α和拉米夫定[3TC])由于副作用或耐药性的产生而限制了长期疗效。富马酸替诺福韦(TDF)是一种具有良好体外抗乙肝病毒活性的核苷酸类似物，对3TC耐药的乙肝病毒变异株也具有良好的抗病毒活性。在这项为期24周的先导性研究中，前瞻性地评估了TDF的抗乙肝病毒活性，对6名3TC和干扰素治疗失败的HIV合并感染的患者进行了研究。在基线时，所有患者都服用了3TC或FTC，且乙肝表面抗原和乙肝e抗原阳性；4名患者患有肝硬变。基线乙肝病毒载量为7.95log(10)拷贝/毫升。12周和24周时，乙肝病毒载量分别下降了3.1log(10)拷贝/毫升和4.3log(10)拷贝/毫升。治疗开始后转氨酶有一过性升高。无一例患者出现HBe抗体。TDF是一种非常有前景的治疗HIV感染者慢性乙肝的药物。
A significant proportion of human immunodeficiency virus (HIV) infected patients are coinfected with hepatitis B virus (HBV). Currently available treatments for chronic hepatitis B (interferon [IFN]-alpha and lamivudine [3TC]) have limited long-term utility because of side effects or of the development of resistance. Tenofovir disoproxil fumarate (TDF) is a nucleotide analog with excellent activity in vitro against HBV, which is also active against 3TC-resistant HBV variants. In this 24-week pilot study, the anti-HBV activity of TDF was prospectively evaluated in a cohort of 6 HIV coinfected subjects for whom 3TC and IFN therapy had previously failed. At baseline, all patients were taking 3TC or FTC and were hepatitis B surface antigen and hepatitis B e antigen positive; 4 had cirrhosis. Baseline HBV load was 7.95 log(10) copies/mL. By weeks 12 and 24, HBV load had decreased by 3.1 log(10) copies/mL and 4.3 log(10) copies/mL, respectively. There was a transient increase of transaminases after the initiation of treatment. No patient developed HBe antibodies. TDF is a very promising drug for the treatment of chronic hepatitis B in HIV-infected individuals.