47例HBeAg阴性慢性乙型肝炎拉米夫定停药后疗效持久性研究

Durability of the effects after cessation of lamivudine for 47 patients with HBeAg-negative chronic hepatitis B

目的:研究HBeAg阴性慢性乙型肝炎(HBeAg阴性慢乙肝)停药后拉米夫定疗效的持久性及影响因素。方法:对47例使用拉米夫定总疗程≥24月、HBV-DNA阴转达18个月以上HBeAg阴性慢乙肝,分别于停药后进行肝脏生化学、HBV-DNA检测和随访观察。结果:停药后3、6、12、24和36个月累计复发率分别为25.5%、25.5%、41.8%、48.3%和54.8%。复发23例,在4、9和12个月的复发累计病例分别占复发病例的52.2%、65.2%和82.6%,复发最长的1例为39个月。停药时的年龄与拉米夫定停药后疗效持久性有关。结论:HBeAg阴性慢乙肝拉米夫定停药后疗效持久性较HBeAg阳性低,年龄轻者复发率低。

Objective： To investigate the durability of the effects after cessation of lamivudine for HBeAgnegative chronic hepatitis B（CHB） patients. Methods： Forty-seven patients subjecting to lamivudine for no less than 24 months and their HBVDNA-negative duration more than 18 months were enrolled in this study. Hepatic biochemical parameters, HBV-DNA determination, and follow-up were determined after cessation of lamivudine. Results： The cumula- tive rate of relapse after 3, 6, 12, 24 and 36 months after cessation of lamivudine was 25.5%, 25.5%, 41.8%, 48. 3% and 54.8%, respectively. Twenty-three patients relapsed and the latest happened on the 39th month. The cumulative relapse ratio at month 4, 9 and 12 was 52.2%. 65.2% and 82.6%, respectively. The durability of the effects after cessation of lamivudine was related to age at the end of treatment. Conclusion： Durability of the effects after cessation of lamivudine of HBeAg-negative patients is lower than that of HBeAg-positive ones. The younger the patient is, the lower the relapse rate.