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首页> 美国卫生研究院文献>World Journal of Gastroenterology >Baseline HBV DNA level is the most important factor associated with virologic breakthrough in chronic hepatitis B treated with lamivudine
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Baseline HBV DNA level is the most important factor associated with virologic breakthrough in chronic hepatitis B treated with lamivudine

机译：基线HBV DNA水平是与拉米夫定治疗的慢性乙型肝炎病毒学突破相关的最重要因素

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AIM: To identify the factors associated with virologic breakthrough and to select a subgroup of patients who respond well to lamivudine without developing virologic breakthrough (VBT).METHODS: Of 79 patients who had received lamivudine therapy for 9-57 mo, 34 were HBeAg-positive and 45 were HBeAg-negative, 24 developed virologic breakthrough and 55 did not. Clinical and virologic factors were compared between the two groups.RESULTS: The median duration of therapy was 25 (9-57) mo. Virologic breakthrough was defined as a > 1 log HBV DNA increase following initial suppression. When several factors, including gender, duration of infection, baseline HBV DNA, and baseline ALT in HBeAg-positive chronic hepatitis patients were analyzed by logistic regression, the most important predictor of virologic breakthrough was the baseline HBV DNA (r2 = 0.12, P < 0.05). When HBeAg-postitive chronic hepatitis patients were divided into two groups by a point of 6.6 log HBV DNA, the incidence of virologic breakthough between two groups was significantly different.CONCLUSION: Lamivudine may remain an effective first line therapy for those HBeAg-positive patients with a baseline HBV DNA < 6.6 log10 copies/mL.
机译：目的：确定与病毒学突破有关的因素，并选择对拉米夫定反应良好而未发生病毒学突破（VBT）的患者亚组。方法：在接受拉米夫定治疗9-57 mo的79例患者中，有34例是HBeAg-阳性和HBeAg阴性的有45例，病毒学突破有24例，而55例没有。比较两组的临床和病毒学因素。结果：中位治疗时间为25（9-57）mo。病毒学突破被定义为最初抑制后HBV DNA增加> 1 log。当通过Logistic回归分析包括性别，感染持续时间，基线HBV DNA和基线HBeAg阳性慢性肝炎患者的几个因素时，病毒学突破的最重要预测指标是基线HBV DNA（r 2 < / sup> = 0.12，P <0.05）。当HBeAg阳性慢性肝炎患者按6.6 log HBV DNA分为两组时，两组之间的病毒学突破发生率显着不同。结论：拉米夫定对于那些HBeAg阳性的HBV阳性患者仍可能是有效的一线治疗基线HBV DNA <6.6 log10拷贝/ mL。

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