摘要
背景:慢性乙型肝炎抗病毒治疗的完全应答包括血清HBV DNA低于检测水平和HBeAg血清学转换,HBeAg是评估乙型肝炎治疗效果和停药的监测指标。目的:探讨替比夫定治疗HBeAg阳性慢性乙型肝炎患者时影响HBeAg转阴的因素。方法:采用替比夫定治疗156例HBeAg阳性慢性乙型肝炎患者48周,观察ALT、HBV DNA、HBeAg治疗前后变化,分析治疗前基线HBV DNA载量、ALT水平、HBV DNA降至检测下限的时间对HBeAg转阴和定量的影响。结果:替比夫定治疗48周后,HBV DNA转阴128例(82.1%),ALT恢复正常153例(98.1%),HBeAg转阴52例(33.3%);HBV DNA载量、HBeAg定量、ALT水平均显著降低(P<0.01)。治疗前HBV DNA<107copies/mL、ALT≥200 U/L组的HBeAg转阴率分别显著高于HBV DNA≥107copies/mL、ALT<200 U/L组(46.4%对23.0%,P<0.01;55.2%对16.9%,P<0.01),且HBeAg定量显著降低(P<0.01)。HBV DNA降至检测下限的不同时间组HBeAg转阴率和定量相比差异均有统计学意义(P<0.05)。结论:基线HBV DNA<107copies/mL、ALT水平较高、治疗后HBV DNA降至检测下限的时间对替比夫定治疗48周时HBeAg转阴和定量具有明显的影响。
Background： Complete response to antiviral treatment of chronic hepatitis B includes undetectable HBV DNA and HBeAg seroconversion. Detection of HBeAg is the monitoring indicator for Hepatitis B treatment efficacy and drug withdrawal. Aims： To investigate the influential factors of HBeAg seroconversion with telbivudine treatment in HBeAg- positive chronic hepatitis B patients. Methods： A total of 156 HBeAg-positive chronic hepatitis B patients were treated with telbivudine for 48 weeks. The changes of ALT level, HBV DNA load and HBeAg quantitation before and after the treatment were observed, and the influences of baseline HBV DNA load, ALT level and time of undetectable HBV DNA on HBeAg seroconversion and quantitation were analyzed. Results： After treated with telbivudine for 48 weeks, HBV DNA was undetectable in 128 （82.1%） patients, ALT was normal in 153 （98.1%） patients, HBeAg was negative in 52 （33.3%） patients, and HBV DNA load, HBeAg quantitation and ALT level were significantly decreased （ P 〈 0. 01 ）. The seroconversion rates of HBeAg in patients with baseline HBV DNA load 〈 107 copies/mL group and ALTo〉200 U/L group were significantly higher than those in HBV DNA ~〉 107 copies/mL group and ALT 〈 200 U/L group （46.4% vs. 23.0%, P 〈 O. 01 ; 55.2% vs. 16.9% , P 〈 0.01 ） , respectively ; HBeAg quantitation was also significantly decreased. The HBeAg seroconversion rates and decrease of HBeAg quantitation differed significantly with different time for undeteetable HBV DNA （P 〈 0.05 ）. Conclusions： Baseline HBV DNA 〈 107 copies/mL, high level of ALT and time for undetectable HBV DNA have significant influences on HBeAg seroconversion after treatment with telbivudine for 48 weeks.
出处
《胃肠病学》
2013年第11期683-685,共3页
Chinese Journal of Gastroenterology
