阿德福韦酯治疗HBeAg阴性慢性乙型肝炎疗效与HBV基因型的关系

Correlation between the efficacy of adefovir dipivoxil on HBeAg-negative patients with chronic hepatitis B and HBV genotypes

目的探讨阿德福韦酯(ADV)治疗HBeAg阴性慢性乙型肝炎(chronic hepatitis B,CHB)的疗效与HBV基因型的关系。方法选择71例HBV DNA>1×104copies/ml、ALT>2倍正常值上限、TBIL正常的HBeAg阴性CHB患者,其中B基因型40例,C基因型31例,所有患者均口服ADV10mg,1/d,治疗52周,动态观察治疗过程中HBV DNA和ALT水平的变化。结果在治疗12、24、52周时,B基因型患者ALT变化、血清HBV DNA水平下降≥2log10、完全抑制比例与C基因型患者相比差异无统计学意义(P>0.05)。结论ADV能有效抑制HBeAg阴性CHB患者HBV复制,促进肝功能好转,其疗效与HBV基因型B或C型无关。

Objective To explore the correlation between the efficacy of adefovir dipivoxil （ADV） on HBeAg-negative patients with chronic hepatitis B （CHB）and HBV genotype B and C. Methods Totally 71 HBeAg-negative CHB patients with serum HBV DNA levels 〉 1×10^4 eopies/ml, an ALT levels 〉2 times the upper limit of normal and normal TBIL levels were divided into genotype B group （n=40） and genotype C group （n=31）. All the patients were administered with ADV orally （10 mg once daily） for 52 weeks. HBV DNA and ALT levels were detected at different time during the treatment. Results The differences in ALT levels, the rates of reduction in serum HBV DNA levels （≥2 log10 copies/ml） and the rates of complete suppression of HBV DNA at week 12, 24 and 52 of the treatment were not significant between both groups（P〉0.05）. Conclusions ADV treatment can effectively inhibit HBV replication and significantly improve liver function in HBeAg-negative CHB patients. The therapeutic efficacy of ADV is not associated with HBV genotype B or C.