抗HIV和HBV新药L-D4FC

L-D4FC((-)-β-L-2′,3′-双脱氢-2′,3′-双脱氧-5-氟胞苷)是目前报道中最具效力的抗病毒逆转录酶抑制剂,正处于Ⅱ期临床试验中。最新临床研究结果显示,L-D4FC具有疗效高、耐药性好、抗病毒谱宽、不良反应小等优点。该药兼具抗HBV和HIV双重活性,有可能成为最佳的抗HBV和HIV核苷类似物抑制剂。综述了L-D4FC的药理作用、临床评价及文献合成方法。

苯丙烯酰胺类化合物的设计、合成及抗HBV活性评价

目的合成苯丙烯酰胺类化合物并考察其抗HBV活性。方法以甘氨酸为起始原料,经过与4-硝基苯甲酰氯缩合,再与2-甲氧基苯甲醛环合,所得产物与氨基醇类化合物反应得到目标化合物。采用MTT法评价目标化合物的细胞毒性,实时荧光定量PCR检测细胞中HBV DNA复制程度,分别计算抑制率、IC_(50)及SI。结果制备了6个苯丙烯酰胺类化合物。化合物5a(IC_(50):2.06μmol·L^(-1),SI:26.35)、5b(IC_(50):0.95μmol·L^(-1),SI:69.58)和5c(IC_(50):4.36μmol·L^(-1),SI:19.86)对HBV DNA复制的抑制活性显著好于先导物MTS(IC_(50):12.57μmol·L^(-1),SI>7.96),对HepG2耐药细胞的HBV DNA也具有较强的抑制作用。结论化合物5a^5c具有进一步研究的价值。

Diagnostic and therapeutic progress of multi-drug resistance with anti-HBV nucleos(t)ide analogues

Nucleos(t)ide analogues(NA) are a breakthrough in the treatment and management of chronic hepatitis B.NA could suppress the replication of hepatitis B virus(HBV) and control the progression of the disease.However,drug resistance caused by their long-term use becomes a practical problem,which influences the long-term outcomes in patients.Liver transplantation is the only choice for patients with HBV-related end-stage liver disease.But,the recurrence of HBV after transplantation often caused by the development of drug resistance leads to unfavorable outcomes for the recipients.Recently,the multi-drug resistance(MDR) has become a common issue raised due to the development and clinical application of a variety of NA.This may complicate the antiviral therapy and bring poorly prognostic outcomes.Although clinical evidence has suggested that combination therapy with different NA could effectively reduce the viral load in patients with MDR,the advent of new antiviral agents with high potency and high genetic barrier to resistance brings hope to antiviral therapy.The future of HBV researches relies on how toprevent the MDR occurrence and develop reasonable and effective treatment strategies.This review focuses on the diagnostic and therapeutic progress in MDR caused by the anti-HBV NA and describes some new research progress in this field.

治疗慢性乙型肝炎背景及拉米夫定的评价

目的:慢性乙型肝炎(CHB)是乙型肝炎病毒(HBV)感染的严重后果,是一个世界性难题,数以百万计的病人期待着有效治疗方法。近年来拉米夫定(Iamivudine,3TC)研究课题,为抗HBV治疗开辟了新途径。方法:以近年发表的文献为基础,就3TC作用机制、临床应用情况、存在问题进行综述。结果与结论:3TC经5年临床研究证明,治疗CHB已初露曙光,但亟待解决问题很多,针对这些问题专家们提出临床应用指导意见。