Efficacy of different antiviral treatments for chronic hepatitis B patients carrying different genotypes of hepatitis B virus
- Author:
- No author available
- Journal Title:
- World Chinese Journal of Digestology
- Issue:
- 35
- DOI:
- 10.11569/wcjd.v24.i35.4704
- Key Word:
- 慢性乙型肝炎;乙型肝炎肝硬化;抗病毒治疗;基因分型;疗效;Chronic hepatitis B;Hepatitis B associated liver cirrhosis;Antiviral treatment;Genotyping;Curative effect
Abstract： 目的 探讨乙型肝炎病毒(hepatitis B virus,HBV)基因分型经不同抗病毒治疗后疗效.方法 选择120例乙型肝炎肝硬化患者和120例慢性乙型肝炎(chronic viral hepatitis B,CHB)患者,乙型肝炎肝硬化患者采用恩替卡韦治疗,观察治疗效果和不同基因型疗效差异.CHB患者随机数字表法分为A、B、C、D4组,每组30例,分别采用拉米夫定、恩替卡韦、拉米夫定联合阿德福韦酯、聚乙二醇干扰素α-2a治疗,4组均治疗96 wk.比较组间疗效差异.结果 120例乙型肝炎肝硬化患者治疗后HBVDNA均表现出明显下降趋势,至治疗96 wk后,HBV DNA平均下降5.13拷贝/mL;至治疗96 wk后,HBV DNA阴转率、谷丙转氨酶(alanine transaminase,ALT)复常率分别达94.17％和76.67％;84例乙型肝炎e抗原(hepatitis B e antigen,HBeAg)阳性患者HBeAg阴转率和血清HBeAg转换率分别达27.38％、22.62％;C型和B型患者抗病毒治疗后HBV DNA阴转率、ALT复常率、HBeAg阴转率、血清HBeAg转换率以及乙型肝炎表面抗原定量比较差异均无统计学意义(P＞0.05).A、B、C、D4组HBVDNA阴转率、ALT复常率、HBeAg阴转率、血清HBeAg转换率比较差异有统计学意义(P＜0.05),其中C组HBVDNA阴转率、ALT复常率、HBeAg阴转率、血清HBeAg转换率最高且显著高于其他3组,A、B和D组3组间HBV DNA阴转率、ALT复常率、HBeAg阴转率、血清HBeAg转换率两两比较差异均无统计学意义(P＞0.05).结论 恩替卡韦治疗乙型肝炎肝硬化疗效显著,且不受基因型影响,不同抗病毒方案治疗CHB均能取得一定效果,以拉米夫定联合阿德福韦酯方案效果最优.
- [1]李晓玲.恩替卡韦抗病毒治疗乙型肝炎肝硬化患者临床疗效探总[J].2015,(48).
- [2]慢性乙型肝炎特殊患者抗病毒治疗专家委员会.慢性乙型肝炎特殊患者抗病毒治疗专家共识：2015年更新[J].2015,(8).
- [3]陆志檬.慢性乙型肝炎抗病毒治疗方案探讨[J].2012,(9).
- [4].病毒性肝炎的诊断标准[J].2001,(1).
- [5]慢性乙型肝炎联合治疗专家委员会.慢性乙型肝炎联合治疗专家共识[J].2012,(1).
- [6]中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南（2015更新版）[J].2015,(12).
- [7]Yan Xu,Yong-Gui Zhang,Xu Wang,etc.Long-term antiviral efficacy of entecavir and liver histology improvement in Chinese patients with hepatitis B virus-related cirrhosis[J].2015,(25).
- [8]黄亚琴,杨丽莎,吴淋玲.HBV基因型在HBV感染性肝癌及慢性HBV感染自然史不同阶段的分布[J].2011,(12).
- [9]Li, Guo-Jun,Yu, Yi-Qi,Chen, Shao-Long,etc.Sequential Combination Therapy with Pegylated Interferon Leads to Loss of Hepatitis B Surface Antigen and Hepatitis B e Antigen (HBeAg) Seroconversion in HBeAg-Positive Chronic Hepatitis B Patients Receiving Long-Term Entecavir Treatment[J].2015,59(7).
- [10]Hasan Tahsin Gozdas,Erkan Arpaci.Use of entecavir in hepatitis B virus reactivation of a patient with non-Hodgkin's lymphoma[J].2015,(35).
- [11]Xiu-Li, Chen,Man, Li,Xiao-Lan, Zhang.HBV genotype B/C and response to lamivudine therapy: a systematic review.[J].2013,2013.
- [12].The global burden of liver disease: The major impact of China[J].2014,60(6).
- [13]Trepo C,Canva V,Cales P,etc.Characteristics of patients with chronic hepatitis B in France: Predominant frequency of HBe antigen negative cases.[J].2006,45(3).
- [14]Ya-Ping Liao,Jia-Lu Jiang,Wai-Yi Zou,etc.Prophylactic antiviral therapy in allogeneic hematopoietic stem cell transplantation in hepatitis B virus patients[J].2015,(14).
- [15]Tran TT,Martin P.Hepatitis B: epidemiology and natural history.[J].2004,8(2).