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首页> 外文期刊>World Journal of Gastroenterology >Long-term lamivudine treatment for chronic hepatitis B in Japanese patients: a project of Kyushu University Liver Disease Study.
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Long-term lamivudine treatment for chronic hepatitis B in Japanese patients: a project of Kyushu University Liver Disease Study.

机译：拉米夫定长期治疗日本慢性乙型肝炎：九州大学肝脏疾病研究项目。

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AIM: To determine the efficacy of long-term lamivudine treatment of a large number of Japanese patients with chronic hepatitis B. METHODS: In this retrospective, multi-center trial, 318 Japanese patients with chronic hepatitis B received 100 mg of lamivudine daily for up to 36 (median 21) mo. Virological response was a decline to a serum HBV DNA level less than 3.7 log copies/mL. Virological breakthrough was defined as the reappearance of a serum HBV DNA level to more than 10-fold the minimum during treatment.RESULTS: Lamivudine produced virological response in 86.8% of the 318 patients at 6 mo, in 80.2% of 252 patients at 12 mo, in 69.2% of 133 patients at 24 mo, and in 53.6% of 28 patients at 36 mo. Forward stepwise logistic regression analysis showed an HBV DNA level less than 6.8 log copies/mL (P<0.0001), HBeAg negativity (P<0.0001), a platelet count of 100 x 10(9)/L or more (P=0.0162) at baseline, and a decline of the HBV DNA level of more than 3.2 log copies/mL as compared with the baseline levelat 3 mo after the start of treatment (P=0.0003) to be significantly associated with virological response. Among patients with a virological response, virological breakthrough was seen in 5.3% of 19 patients who responded virologically at 1 mo, in 20.7% of 203 patients at 3 mo, in 27.5% of 51 patients at 6 mo, in 33.3% of 12 patients at 9 mo, and in 100% of 3 patients at >=5 mo. A virological breakthrough was found significantly more often in patients with delayed virological response.CONCLUSION: Lamivudine treatment could suppress serum HBV DNA in most of the tested Japanese patients. Long-term efficacy might be seen in patients without HBeAg at baseline, in the absence of cirrhosis, and in patients with a decline in HBV DNA level soon after the start of treatment.
机译：目的：确定长期拉米夫定对大量日本慢性乙型肝炎患者的疗效。方法：在这项回顾性，多中心试验中，318名日本慢性乙型肝炎患者每天接受100 mg拉米夫定治疗至36（中位数21）个月。病毒学应答是血清HBV DNA水平下降到小于3.7 log拷贝/ mL。病毒学突破被定义为在治疗期间血清HBV DNA水平再次出现最低值的10倍以上。结果：拉米夫定在6个月时的318例患者中有86.8％产生了病毒学应答，在12个月时的252例患者中有80.2％产生了病毒学应答。 ，在133位患者的24个月中占69.2％，在28位患者的36.mo中占53.6％。逐步逐步Logistic回归分析显示HBV DNA水平低于6.8 log拷贝/ mL（P <0.0001），HBeAg阴性（P <0.0001），血小板计数为100 x 10（9）/ L或更高（P = 0.0162）在治疗开始后3个月（P = 0.0003），与基线水平相比，HBV DNA水平下降超过3.2 log拷贝/ mL以上（P = 0.0003），这与病毒学应答显着相关。在有病毒学应答的患者中，在1个月时发生病毒学应答的19例患者中有5.3％出现病毒学突破，在3个月时203例患者中占20.7％，在6个月时51例患者中27.5％发生了病毒学突破，在12例患者中占33.3％在9 mo时，在3％的患者中100％> = 5 mo。在病毒学应答延迟的患者中发现病毒学突破的频率更高。结论：拉米夫定治疗可以抑制大多数接受测试的日本患者的血清HBV DNA。在基线时无HBeAg的患者，无肝硬化的患者以及开始治疗后不久HBV DNA水平下降的患者可能会看到长期疗效。

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