Treatment outcomes of clevudine versus lamivudine at week 48 in naïve patients with HBeAg positive chronic hepatitis B.
Treatment outcomes of clevudine versus lamivudine at week 48 in naïve patients with HBeAg positive chronic hepatitis B.
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DOI：
10.3346/jkms.2010.25.5.738
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发表时间：
2010-05
影响因子：
4.5
通讯作者：
Kim HC
中科院分区：
文献类型：
--
作者：
Kim IH;Lee S;Kim SH;Kim SW;Lee SO;Lee ST;Kim DG;Choi CS;Kim HC
作者评估了48周克来夫定治疗与拉米夫定治疗HBeAg阳性慢性B肝炎初治患者的疗效和抗病毒耐药性。在这项回顾性研究中，共纳入116例HBeAg阳性患者，他们接受克来夫定30 mg每日1次（n=53）或拉米夫定100 mg每日1次（n=63）治疗48周。在第48周，与拉米夫定治疗相比，克来夫定治疗使血清HBV DNA水平较基线显著降低（-5.2 vs. -4.2 log 10 IU/mL; P=0.005）。此外，在第48周，克来夫定组患者中PCR检测血清HBV DNA阴性（<13 IU/mL）的比例显著较高（60.4% vs. 38.1%; P=0.025）。克来夫定组的病毒学突破发生率显著低于拉米夫定组（9.4% vs. 25.4%; P=0.031）。然而，两组丙氨酸氨基转移酶正常化率和HBeAg丢失或血清转换率相似（分别为83.0%和81.0%，11.3%和11.1%; P=0.813，1.000）。总之，在治疗初治HBeAg阳性慢性B型肝炎患者时，与拉米夫定相比，克来夫定在48周时的病毒抑制作用更强，抗病毒耐药率更低。
The authors assessed the efficacy and antiviral resistance of 48-week clevudine therapy versus lamivudine in treatment of naïve patients with HBeAg positive chronic hepatitis B. In this retrospective study, a total of 116 HBeAg positive patients, who received 30 mg of clevudine once daily (n=53) or 100 mg of lamivudine once daily (n=63) for 48 weeks, were included. At week 48, clevudine therapy produced a significantly greater mean reductions in serum HBV DNA levels from baseline than lamivudine therapy (-5.2 vs. -4.2 log10IU/mL; P=0.005). Furthermore, a significantly higher proportion of patients on clevudine achieved negative serum HBV DNA by PCR (<13 IU/mL) at week 48 (60.4% vs. 38.1%; P=0.025). The incidence of virologic breakthrough in the clevudine group was significantly lower than in the lamivudine group (9.4% vs. 25.4%; P=0.031). However, rates of alanine aminotransferase normalization and HBeAg loss or seroconversion were similar in the two groups (83.0% vs. 81.0%, 11.3% vs. 11.1%; P=0.813, 1.000, respectively). In conclusion, clevudine is more potent for viral suppression and lower for antiviral resistance at week 48 than lamivudine in treatment of naïve patients with HBeAg positive chronic hepatitis B.
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