早期病毒应答对拉米夫定治疗慢性乙肝疗效的影响

The Effects of Early Viral Response (EVR) on The Treatment of Chronic Hepatitis B with Lamivudine

研究影响拉米夫定治疗慢性乙肝疗效的因素。对119例HBeAg阳性慢性乙肝患者分别于治疗前、治疗4、12、24和48周时对ALT水平、HBVDNA和HBeAg定量进行检测,并在治疗24周和48周时对HBeAg血清转换率进行分析。发现治疗前ALT≥3×ULN、HBVDNA<1.5×104fg/ml、出现早期病毒应答者HBeAg血清转换率较高(P<0.01或<0.05)。治疗前,较高的ALT水平、较低的HBVDNA定量值及出现早期病毒应答是影响拉米夫定治疗慢性乙肝疗效的主要因素。

To study the influence of EVR on the treatment of chronic hepatitis B with Lamivudine.119 patients who were chronic hepatitis B with HBeAg positive were treated with lamivudine for 6～12 months.ALT values,quantitative HBeAg and HBV DNA were seperately tested before treatment,and week 4,12,24,and 48 after starting therapy.The HBeAg seroconversion rates were analysed at week 24 and 48,the HBeAg seroconversion rates in baseline ALT≥3×ULN group、baseline HBV DNA<1.5×104fg/ml group and HBeAg decreased more than 50% at week 4 group were significantly higher than baseline ALT<3×ULN group、baseline HBV DNA≥1.5×104fg/ml group and HBeAg decreased less than 50% at week 4 group(P<0.01 or 0.05)respectively.Higher baseline ALT,lower baseline HBV DNA levels and the HBeAg decline more than 50% at the early stage of treatment(with EVR) are significant predictors of HBeAg seroconversion for Lamivudine treatment.