摘要
瞄准:与长期的肝炎 B 决定很多日本病人的长期的 lamivudine 治疗的功效。方法:在这回顾,多中心试用,有长期的肝炎 B 的 318 个日本病人每天为多达 36 收到了 lamivudine 的 100 mg (中部 21 ) 瞬间。Virological 反应是到浆液 HBV DNA 水平的衰落不到 3.7 木头 copies/mL。当浆液 HBV DNA 的再现在 treatment.RESULTS 期间铺平最小到超过 10 褶层, Virological 突破被定义:Lamivudine 在 6 瞬间在 318 个病人中的 86.8% 个生产了 virological 反应,在在 12 瞬间的 252 个病人中的 80.2% 个,在在 24 瞬间的 133 个病人中的 69.2% 个,并且在在 36 瞬间的 28 个病人中的 53.6% 个。向前逐步的逻辑回归分析证明 HBV DNA 铺平不到 6.8 木头 copies/mL ( P【0.0001 ), HBeAg 否定性( P【0.0001 ), 100 x 10 的一个血小板计数( 9 )在基线的 /L 或更多( P=0.0162 ),并且超过 3.2 木头 copies/mL 的 HBV DNA 水平的衰落在治疗( P=0.0003 )的开始以后在 3 瞬间作为与基线相比铺平显著地与 virological 反应被联系。在有 virological 回答的病人之中, virological 突破在在 1 瞬间 virologically 反应了的 19 个病人中的5.3%个被看见,在在 3 瞬间的 203 个病人中的20.7%个,在在 6 瞬间的 51 个病人中的27.5%个,在在 9 瞬间的 12 个病人中的33.3%个,并且在在 】=5 瞬间的 3 个病人的100%。virological 突破与推迟的 virological response.CONCLUSION 在病人更经常显著地被发现:Lamivudine 治疗能在大多数测试日本病人压制浆液 HBV DNA。没有 HBeAg,长期的功效可能在基线在病人被看见,当肝硬化不在时,并且在有在 HBV 的衰落的病人, DNA 此后不久铺平治疗的开始。
AIM: To determine the efficacy of long-term lamivudine treatment of a large number of Japanese patients with chronic hepatitis B. METHODS: In this retrospective, multi-center trial, 318 Japanese patients with chronic hepatitis B received 100 mg of lamivudine daily for up to 36 (median 21) mo. Virological response was a decline to a serum HBV DNA level less than 3.7 log copies/mL. Virological breakthrough was defined as the reappearance of a serum HBV DNA level to more than 10-fold the minimum during treatment.
RESULTS: Lamivudine produced virological response in 86.8% of the 318 patients at 6 mo, in 80.2% of 252 patients at 12 mo, in 69.2% of 133 patients at 24 mo, and in 53.6% of 28 patients at 36 mo. Forward stepwise logistic regression analysis showed an HBV DNA level less than 6.8 log copies/mL (P〈 0.0001), HBeAg negativity (P〈 0.0001), a platelet count of 100×10^9/L or more (P= 0.0162) at baseline, and a decline of the HBV DNA level of more than 3.2 log copies/mL as compared with the baseline level at 3 mo after the start of treatment (P= 0.0003) to be significantly associated with virological response. Among patients with a virological response, virological breakthrough was seen in 5.3% of 19 patients who responded virologically at 1 mo, in 20.7% of 203 patients at 3 mo, in 27.5% of 51 patients at 6 mo, in 33.3% of 12 patients at 9 mo, and in 100% of 3 patients at ≥15 mo. A virological breakthrough was found significantly more often in patients with delayed virological response.
CONCLUSION: Lamivudine treatment could suppress serum HBV DNA in most of the tested Japanese patients. Long-term efficacy might be seen in patients without HBeAg at baseline, in the absence of cirrhosis, and in patients with a decline in HBV DNA level soon after the start of treatment.