摘要
目的探讨聚乙二醇干扰素治疗HBe Ag阳性慢性乙肝52周部分应答患者换用替比夫定的疗效及安全性。方法对聚乙二醇干扰素治疗HBe Ag阳性慢性乙肝52周时部分应答患者改用替比夫定(600 mg、1/d)继续治疗,分别于0、12、24、36及48周检测HBe Ag、HBs Ag、HBV DNA、血清谷丙转氨酶(ALT)及肌酸激酶水平。结果基线ALT水平影响干扰素抗病毒疗效(P=0.026)。换用替比夫定治疗后,血清HBV DNA在24周时全部阴转,HBe Ag转换率由12周时的31.3%,增至48周时的62.5%,HBs Ag水平进一步降低,治疗过程中无明显不良反应。结论干扰素部分应答患者换用替比夫定能使HBV DNA及HBs Ag水平进一步降低,提高HBe Ag血清学转换率,安全性好,值得借鉴。
Objective To investigate the efficacy and safety of switched to telbivudine treatment for 48 weeks in HBe Agpositive chronic hepatitis B patient with poor responses after 52-week pegylated interferon alpha-2a therapy. Methods Patients with poor responses after 52-week pegylated interferon alpha-2a therapy were switched to telbivudine treatment（600 mg,1 / day）. At 0（baseline）, 12, 24, 36 and 48 weeks, the levels of HBe Ag, HBs Ag, HBV DNA, serum ALT and CK were measured. Results Baseline ALT levels affect the antiviral efficacy of interferon（P =0.026）. After switched to telbivudine treatment, serum levels HBV DNA of all patients were undetectable at 24 weeks; HBe Ag seroconversion rate was increased from 31.3% at 12 weeks to 62.5% at 48 weeks. The mean HBs Ag level was also reduced significantly and no significant side effect occurred over telbivudine treatment. Conclusion Telbivudine treatment can further reduce HBV DNA and HBs Ag levels and increase the HBe Ag seroconversion rate in HBe Ag-positive chronic hepatitis B patient with poor responses for pegylated interferon alpha-2a therapy.
出处
《热带医学杂志》
CAS
2014年第12期1585-1587,共3页
Journal of Tropical Medicine
关键词
慢性乙肝
替比夫定
聚乙二醇干扰素
chronic hepatitis B
telbivudine
pegylated interferon alpha-2a
