[Effect of initial virologic response to adefovir on the development of resistance to adefovir in lamivudine-resistant chronic hepatitis B].
[Effect of initial virologic response to adefovir on the development of resistance to adefovir in lamivudine-resistant chronic hepatitis B].
复制标题
[阿德福韦初始病毒学反应对拉米夫定耐药慢性乙型肝炎阿德福韦耐药发展的影响]。
DOI：
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Dae
中科院分区：
文献类型：
--
作者：
I. Kim;S. Kim;Hyun Chul Kim;Kyoung;Sang Wook Kim;Seung Ok Lee;Soo;Dae
背景/目标
拉米夫定耐药的慢性乙肝患者对阿德福韦酯(ADV)的耐药性尚不清楚。这项研究检测了对ADV的初始病毒学应答(IVR)、ADV耐药率以及与ADV耐药性相关的因素。
方法
81名拉米夫定耐药的HBeAg阳性患者参加了这项研究。IVR定义为治疗6个月后HBVdna和4log10拷贝数/毫升。
结果
IVR发生率为45.7%(37/81)，与治疗前ALT升高(P=0.002)、HBVDNA水平降低(P=0.015)有关。12个月、18个月和24个月时，非IVR患者的HBVDNA水平显著高于IVR患者(分别为4.73vs2.59、4.53vs2.31、4.39vs2.40log10拷贝/毫升；P<0.01)。在随访期内，17例(21.0%)患者表现出对ADV的表型耐药，9例(11.1%)患者出现了ADV耐药突变。12个月和24个月对ADV的累积抗性概率分别为8.7%和32.5%。12个月和24个月对ADV的累积抗性概率分别为0%和14.6%。对ADV的耐药性与治疗前HBVdna水平较高(P=0.019)和非静脉输注(P<；0.001)有关。
结论
24月龄时对ADV的表型和基因抗性累积概率分别为32.5%和14.6%。治疗前高HBVDNA和非IVR(治疗6个月后HBVDNA/gt；=4log10拷贝/ml)与ADV耐药有关。
BACKGROUND/AIMS
Adefovir dipivoxil (ADV) resistance in patients with lamivudine-resistant chronic hepatitis B is not well understood. This study examined the initial virologic response (IVR) to ADV, the rate of ADV resistance and the factors associated with ADV resistance.
METHODS
Eighty one lamivudine-resistant HBeAg-positive patients were enrolled in this study. IVR was defined as HBV DNA < 4 log10 copies/mL after 6 months of therapy.
RESULTS
IVR was observed in 37/81(45.7%) patients and it was associated with higher pretreatment ALT (P=0.002), and low pretreatment HBV DNA level (P=0.015). The HBV DNA levels were significantly higher in the non-IVR patients than the IVR patients at 12, 18 and 24 months (4.73 vs 2.59, 4.53 vs 2.31, 4.39 vs 2.40 log10 copies/mL, respectively; P<0.01). During the follow-up period, 17(21.0%) patients showed phenotypic resistance to ADV and 9 (11.1%) patients had ADV-resistant mutations. The cumulative probabilities of the phenotypic resistance to ADV at 12 and 24 months were 8.7% and 32.5%, respectively. The cumulative probabilities of the genotypic resistance to ADV at 12 and 24 months were 0% and 14.6%, respectively. Resistance to ADV was associated with a higher pretreatment HBV DNA (P=0.019), and non-IVR (P<0.001).
CONCLUSIONS
The cumulative probabilities of the phenotypic and genotypic resistance to ADV at 24 months were 32.5% and 14.6%. The high pretreatment HBV DNA and non-IVR (HBV DNA >/= 4 log10 copies/mL after 6 months of therapy) were associated with ADV resistance.
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影响因子：
11.8
作者：
Lai, CL;Dienstag, J;Condreay, L
通讯作者：
Condreay, L
影响因子：
158.5
作者：
Dienstag, JL;Schiff, ER;Brown, NA
通讯作者：
Brown, NA
影响因子：
29.4
作者：
Lok, ASF;Lai, CL;Castiglia, M
通讯作者：
Castiglia, M
肝上皮细胞中膜转运蛋白的调节囊泡运输。
DOI：
10.1016/j.jhep.2005.01.001
发表时间：
2005
期刊：
Journal of hepatology.
影响因子：
--
作者：
Marinelli,RaulA;Tietz,PamelaS;Larusso,NicholasF
通讯作者：
Larusso,NicholasF