阿德福韦抗乙肝病毒感染治疗动力学模型

Dynamic mathematical model for adefovir dipivoxil anti-HBV treatment

基于阿德福韦(Adefovir dipivoxil)与安慰剂治疗180余位HBeAg阴性的慢性乙型肝炎(CHB)患者国际联合研究的临床数据,以及Nowak等人提出的不带效应细胞的乙肝病毒(HBV)感染模型,提出了一个由两个系统组成的数学模型,模型对CHB患者的阿德福韦治疗效果提供了一种可能的解释,特别是可以解释为什么患者血浆中病毒数目在停止免疫治疗后会迅速反弹.该模型对长期的疗效做出预测:血清HBV DNA接近中位数的患者需要延长治疗时间到5.6a,以清除CHB患者体内的HBV.本研究提示:将血清DNA小于500copies·mL-1作为评价疗效的标准过于粗糙.

Based on over 180 HBeAg negative patients＇ anti-HBV infection therapy data of adefovir dipivoxil with placebo for an international co-operation research and the HBV infection dynamic model proposed by Nowak et al, a mathematical model consisting of two differential equation systems was built. This model provided a possible interpretation of the curative effect of adefovir dipivoxil with placebo for HbeAg negative chronic HBV infection patients, particularly explaining why the plasma virus of the patients turnover after stopping the adefovir dipivoxil therapy. This model predicts the long time adefovir dipivoxil curative effect that the patients whose plasma HBV DNAs is near the median values need to prolong treatment time until 5.6 years to delete HBV virus in bodies. This research implies also that the popular treatment standard of HBV DNA（ 500 copies· mL^- 1 is too rough to evaluate the effectiveness for aniti-HBV infection therapy.