摘要
AIM： To assess the effectiveness and side-effects of lamivudine therapy for children with chronic hepatitis B （CHB） who fail to respond to or have contraindications to interferon-α （IFN-α） therapy. METHODS： Fifty-nine children with CHB were treated with 100 mg lamivudine tablets given orally once daily for 12 too. Alanine aminotransferase （ALT） activity was evaluated monthly during the therapy and every 3 months after its discontinuation. HBe antigen, antiHBe antibodies, HBV DNA level in serum were evaluated at baseline and every six months during and after the lamivudine therapy. Sustained viral response （SVR） to lamivudine therapy was defined as permanent （not shorter than 6 mo after the end of the therapy）, namely ALl＂ activity normalization, seroconversion of HBeAg to anti-HBe antibodies, and undetectable viral HBV-DNA in serum （lower than 200 copies per mL）. The analysis of the side-effects of the lamivudine treatment was based upon interviews with the patients and their parents using a questionnaire concerning subjective and objective symptoms, clinical examinations, and laboratory tests performed during clinical visits monthly during the therapy, and every 3 mo after the therapy. RESULTS： ALT normalisation occurred in 47 （79.7%） patients between the first and 11^th mo of treatment （mean 4.4±2.95 mo, median 4.0 mo）, and in 18 （30.5%） of them after 2 mo of the therapy. There was no correlation between the time of ALT normalization and the children＇s age, the age of HBV infection, the duration of HBV infection, inflammation activity score （grading）, staging, ALT activity before treatment, serum HBV DNA level, and lamivudnie dose per kg of body weight. HBeAg/anti HBe seroconversion was achieved in 27.1% of cases.The higher rate of seroconversion was connected with lower serum HBV DNA level and longer duration of HBV infection. There was no connection between HBeAg/ anti HBeAb seroconversion and the children＇s age, age of HBV infection, grading, staging, ALT activity before treatment, and lamivudnie dose per kg of body weight. No complaints or clinical symptoms were observed during lamivudine therapy. Impairment of renal function or myelotoxic effect was noted in none of the patients. CONCLUSION： One year lamivudine therapy for children with chronic hepatitis B is effective and well tolerated. Seroconversion of HBeAg/HBeAb and SVR are connected with lower pre-treatment serum HBV DNA level.
瞄准：为了估计，为失败到的有长期的肝炎 B (CHB ) 的孩子的 lamivudine 治疗的有效性和副作用对作出回应或有禁止徵候到 interferon-alpha (IFN-alpha ) 治疗。方法：有 CHB 的 59 个孩子被对待， 100 片 mg lamivudine 药片每天为 12 瞬间口头上地给一次。丙氨酸 aminotransferase (中高音) 活动在它的中止以后在治疗和每 3 瞬间期间每月被评估。HBe 抗原， anti-HBe 抗体，在浆液的 HBV DNA 水平在基线和每六个月被评估在期间并且在 lamivudine 治疗以后。对 lamivudine 治疗的持续病毒的反应(SVR ) 被定义为永久(比在治疗的结束以后的 6 瞬间不短) ，也就是中高音活动正规化，到 anti-HBe 抗体的 HBeAg 的 seroconversion，和在浆液的无法发现的病毒的 HBV-DNA (比 200 个拷贝低每 mL ) 。lamivudine 治疗的副作用的分析有关测试在治疗以后在治疗，和每 3 瞬间期间每月在临床的访问期间执行了的主观、客观的症状，临床的考试，和实验室用一张问询表在病人和他们的父母的会见之上被基于。结果：中高音 normalisation 发生在 47 (79.7%) 病人在之间第一和 11 (th ) 治疗的瞬间(吝啬的 4.4+/-2.95 瞬间，中部 4.0 瞬间) ，并且在 18 (30.5%) 他们在治疗的 2 瞬间以后。在中高音正规化和孩子们的年龄的时间之间没有关联， HBV 感染的年龄， HBV 感染的持续时间，发炎活动分数(分级) ，阶段，在治疗前的中高音活动，浆液 HBV DNA 水平，和 lamivudine 每体重的 kg 开。HBeAg/anti HBe seroconversion 在 27.1% 盒子中被完成。seroconversion 的更高的率与更低的浆液 HBV DNA 水平和 HBV 感染的更长的持续时间被连接。在 HBeAg/anti HBeAb seroconversion 和孩子们之间没有连接，分级是年龄， HBV 感染的年龄，阶段，在治疗前的中高音活动，和 lamivudnie 每体重的 kg 开。没有抱怨或临床的症状在 lamivudine 治疗期间被观察。肾的功能或骨髓中毒的效果的缺陷病人在没有被注意。结论：为有长期的肝炎 B 的孩子的一年 lamivudine 治疗有效、很好容忍。HBeAg/HBeAb 和 SVR 的 Seroconversion 与更低的预告的处理浆液 HBV DNA 水平被连接。
