基线病毒载量对阿德福韦酯治疗HBeAg阳性慢性乙型肝炎疗效的影响  

The impact of baselining viral load on efficacy of adefovir dipivoxil in treatment of patients with HBeAg-positive chronic hepatitis B

作　　者：阮炳威[1] 陆小蒟[1] 曾广忠[1] 刘雁平[1] 陈荣策[2] 

机构地区：[1]广东省江门市人民医院感染病科,529051 [2]广东省江门市人民医院检验科,529051

出　　处：《实用肝脏病杂志》2013年第3期235-237,共3页Journal of Practical Hepatology

摘　　要：目的探讨不同基线病毒载量HBeAg阳性慢性乙型肝炎患者应用ADV抗病毒治疗的疗效。方法根据基线HBV DNA水平不同将72例HBeAg阳性慢性乙型肝炎患者分为低病毒载量组(A组)44例和高病毒载量组(B组)28例。A组HBV DNA<1×107拷贝/毫升,B组HBV DNA≥1×107拷贝/毫升,均应用ADV治疗,观察48周。结果在治疗12周、24周和48周时,A组HBV DNA水平分别为3.5±1.1lg拷贝/毫升、3.0±1.1lg拷贝/毫升和2.6±1.2lg拷贝/毫升,B组分别为3.8±1.3lg拷贝/毫升、3.6±1.3lg拷贝/毫升和3.1±1.4lg拷贝/毫升,其中仅在24周时两组差异有统计学意义(P<0.05);治疗12周时A组HBV DNA阴转率为18.2%、HBeAg阴转率为15.2%,HBeAg血清转换率为9.1%、ALT复常率为54.5%,B组分别为3.6%、10.7%、10.7%、32.1%,差异无统计学意义(P>0.05);24周A组HBV DNA阴转率为34.9%、HBeAg阴转率为27.9%,HBeAg血清转换率为11.6%、ALT复常率为86.0%,B组分别为14.3%、14.3%、10.7%、57.1%,仅ALT复常率差异有统计学意义(P<0.05);48周A组HBV DNA阴转率为52.3%、HBeAg阴转率为45.5%,HBeAg血清转换率为6.8%、ALT复常率为90.9%,B组则分别为25.9%、11.1%、7.4%、70.4%,除HBeAg血清转换率外,两组差异均有统计学意义(P<0.05);治疗48周A组发生病毒学突破1例,B组3例,差异无统计学意义(P>0.05)。结论基线病毒载量是影响ADV治疗CHB疗效的重要因素,并可作为疗效预测的重要参考依据。Objective To investigate the impact of baselining viral load on efficacy of adefovir dipivoxil（ADV）in treatment of patients with HBeAg-positive chronic hepatitis B.Methods 72 patients with HBeAg-positive chronic hepatitis B were divided into two groups,and group A included 44 cases with low（lower than 1×107copies/ml）and group B included 28 cases with high（higher than or equal to 1×107copies/ml） serum viral load.All patients were treated with ADV for 48 weeks.Results Serum HBV DNA levels in group A at week 12,24 and 48 were 3.5±1.1lg copies/ml,3.0±1.1 lg copies/ml（P0.05）,2.6±1.2lg copies/ml,and in group B were 3.8±1.3lg copies/ml,3.6±1.3lg copies/ml and 3.1±1.4lg copies/ml,recpectively;at the end of week 12,the rates of HBV DNA loss,HBeAg negativity,HBeAg/anti-HBe seroconversion and ALT normalization in group A were 18.2%,15.2%,9.1%,54.5%,and in group B were 3.6%,10.7%,10.7%,32.1%,respectively（P0.05）;At the end of week 24,the ALT normalization rate in group A was 86.0%,much higher than 57.1% in group B（P0.05）;At the end of week 48,the rates of HBV DNA loss,HBeAg negativity,HBeAg/anti-HBe seroconversion and ALT normalization in group A were 52.3%,45.5%,6.8%,90.9%,and in group B were 25.9%,11.1%,7.4%,70.4%,respectively.Conclusion The baseline viral load in patient with chronic hepatitis B will impact the response to adefovir dipivoxil therapy.

关 键 词：慢性乙型肝炎 阿德福韦酯 疗效 

分 类 号：R512.62[医药卫生—内科学]