AIM:To evaluate virological response to adefovir(ADV) monotherapy and emergence of ADV-resistant mutations in lamivudine(LAM)-resistant chronic hepatitis B patients.METHODS:Seventy-seven patients with documented LAM r...AIM:To evaluate virological response to adefovir(ADV) monotherapy and emergence of ADV-resistant mutations in lamivudine(LAM)-resistant chronic hepatitis B patients.METHODS:Seventy-seven patients with documented LAM resistance who were treated with 10 mg/d ADV for>96 wk were analyzed for ADV resistance.RESULTS:At week 48 and 96,eight(10%)and 14(18%)of 77 LAM-resistant patients developed the ADV-resistant strain(rtA181V/T and/or rtN236T mutations),respectively.Hepatitis B virus(HBV)DNA levels during therapy were significantly higher in patients who developed ADV resistance than in those who did not.Incidence of ADV resistance at week 96 was 11%,8%and 6%among patients with complete virological response(HBV DNA level<60 IU/mL);0%,5%and 19%among patients with partial virological response(HBV DNA level≥60 to 2000 IU/mL);and 32%,34% and 33%among patients with inadequate virological response(HBV DNA levels>2000 IU/mL)at week 12,week 24 and week 48,respectively.HBV DNA levels >2000 IU/mL at week 24 showed best performance characteristics in predicting ADV resistance.CONCLUSION:Development of ADV resistance mutations was associated with HBV DNA levels,which could identify patients with LAM resistance who are likely to respond to ADV monotherapy.展开更多
In Denmark, actions to mitigate the risk related to antimicrobial resistance have been put in place continuously. Due to an increase in the consumption of antimicrobials in the Danish pig production further actions we...In Denmark, actions to mitigate the risk related to antimicrobial resistance have been put in place continuously. Due to an increase in the consumption of antimicrobials in the Danish pig production further actions were implemented in July 2010. These were： a voluntary ban on use of cephalosporin in Danish swine herds for a 2-year period and a so-called Yellow Card scheme from the DVFA （Danish Veterinary and Food Administration）. Farmers with the highest use of antibiotics receive a Yellow Card. In 2010, approximately 10% of Danish herds were above the Yellow Card threshold value. The consumption of antimicrobials in pigs is evaluated as ADD （animal daily doses） per 100 animals over the last 9 months （by age group）. Current permit limits for a Yellow Card in ADD/100 animal days are 5.2 （sows and piglets）, 28 （weaners）, and 8 （finishers）. In July 2010, farmers with an antimicrobial use close to these limits were warned by the DVFA, that unless actions were taken to reduce their antimicrobial use, they would receive a Yellow Card in December 2010. The means are, for instance, restrictions on oral medication usage and supervision from the authorities to which most expenses are to be covered by the farmer. The warning resulted in a decrease in the national consumption to pigs of 12.5% during the last half-year of 2010 compared to the same half-year in 2009. This decrease continued into 2011 where the consumption in January-February was 24.5% lower than for January-February 2010.展开更多
文摘AIM:To evaluate virological response to adefovir(ADV) monotherapy and emergence of ADV-resistant mutations in lamivudine(LAM)-resistant chronic hepatitis B patients.METHODS:Seventy-seven patients with documented LAM resistance who were treated with 10 mg/d ADV for>96 wk were analyzed for ADV resistance.RESULTS:At week 48 and 96,eight(10%)and 14(18%)of 77 LAM-resistant patients developed the ADV-resistant strain(rtA181V/T and/or rtN236T mutations),respectively.Hepatitis B virus(HBV)DNA levels during therapy were significantly higher in patients who developed ADV resistance than in those who did not.Incidence of ADV resistance at week 96 was 11%,8%and 6%among patients with complete virological response(HBV DNA level<60 IU/mL);0%,5%and 19%among patients with partial virological response(HBV DNA level≥60 to 2000 IU/mL);and 32%,34% and 33%among patients with inadequate virological response(HBV DNA levels>2000 IU/mL)at week 12,week 24 and week 48,respectively.HBV DNA levels >2000 IU/mL at week 24 showed best performance characteristics in predicting ADV resistance.CONCLUSION:Development of ADV resistance mutations was associated with HBV DNA levels,which could identify patients with LAM resistance who are likely to respond to ADV monotherapy.
文摘In Denmark, actions to mitigate the risk related to antimicrobial resistance have been put in place continuously. Due to an increase in the consumption of antimicrobials in the Danish pig production further actions were implemented in July 2010. These were： a voluntary ban on use of cephalosporin in Danish swine herds for a 2-year period and a so-called Yellow Card scheme from the DVFA （Danish Veterinary and Food Administration）. Farmers with the highest use of antibiotics receive a Yellow Card. In 2010, approximately 10% of Danish herds were above the Yellow Card threshold value. The consumption of antimicrobials in pigs is evaluated as ADD （animal daily doses） per 100 animals over the last 9 months （by age group）. Current permit limits for a Yellow Card in ADD/100 animal days are 5.2 （sows and piglets）, 28 （weaners）, and 8 （finishers）. In July 2010, farmers with an antimicrobial use close to these limits were warned by the DVFA, that unless actions were taken to reduce their antimicrobial use, they would receive a Yellow Card in December 2010. The means are, for instance, restrictions on oral medication usage and supervision from the authorities to which most expenses are to be covered by the farmer. The warning resulted in a decrease in the national consumption to pigs of 12.5% during the last half-year of 2010 compared to the same half-year in 2009. This decrease continued into 2011 where the consumption in January-February was 24.5% lower than for January-February 2010.
