...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Hepatology: Official Journal of the American Association for the Study of Liver Diseases >Efficacy of entecavir in chronic hepatitis B patients with mildly elevated alanine aminotransferase and biopsy-proven histological damage.
【24h】

Efficacy of entecavir in chronic hepatitis B patients with mildly elevated alanine aminotransferase and biopsy-proven histological damage.

机译：恩替卡韦在慢性乙型肝炎患者中的丙氨酸氨基转移酶轻度升高和活检证实的组织学损害的疗效。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Current guidelines for management of chronic hepatitis B recommend treatment for patients presenting with elevated hepatitis B virus (HBV) DNA and alanine aminotransferase (ALT) >2 x upper limit of normal (ULN) or histological evidence of liver disease. Retrospective analyses have demonstrated that significant hepatic necroinflammation and fibrosis were present in a substantial proportion of patients with ALT 1 to 2 x ULN. To assess therapeutic efficacy in this clinical setting, we retrospectively examined treatment endpoints among the subset of nucleoside-naive chronic hepatitis B (CHB) patients treated in phase 3 clinical trials of entecavir who had both screening and baseline serum ALT 1.3 to 2 x ULN. A total of 1347 patients were randomized to treatment with entecavir or lamivudine. Three hundred thirty-six patients, constituting 25% of the total study population, had screening and baseline ALT 1.3 to 2 x ULN. Clinically significant necroinflammation (Knodell necroinflammation score > or =7) was observed in 60% and 72% of hepatitis B e antigen (HBeAg)-positive and HBeAg-negative patients, respectively, whereas marked fibrosis (Ishak fibrosis score > or =4) was observed in 8% and 15% of HBeAg-positive and HBeAg-negative patients, respectively. Among entecavir-treated HBeAg-negative patients, the proportions of patients achieving histological improvement, HBV DNA <300 copies/mL, and ALT normalization were similar between patients with mildly elevated ALT and those with ALT >2 x ULN. However, entecavir-treated HBeAg-positive patients with mildly elevated ALT had lower response rates for histological improvement, HBV DNA less than 300 copies/mL, ALT normalization, and HBeAg seroconversion than those with ALT greater than 2 x ULN. Conclusion: This retrospective analysis demonstrated that HBeAg-negative CHB patients treated with entecavir responded similarly irrespective of baseline ALT level. However, HBeAg-positive patients with mildly elevated ALT responded less well to treatment with entecavir than did those with ALT greater than 2 x ULN.
机译：当前的慢性乙型肝炎治疗指南建议对表现为乙型肝炎病毒（HBV）DNA和丙氨酸氨基转移酶（ALT）升高> 2 x正常上限（ULN）或肝病组织学证据的患者进行治疗。回顾性分析表明，ALT 1至2 x ULN的患者中有相当一部分存在明显的肝坏死性炎症和纤维化。为了评估在这种临床环境中的治疗效果，我们回顾了恩替卡韦的3期临床试验中接受过核苷纯净慢性乙型肝炎（CHB）患者亚组的治疗终点，这些患者同时进行了筛查和基线血清ALT 1.3至2 x ULN。共有1347名患者被随机分配接受恩替卡韦或拉米夫定治疗。 336名患者（占研究总数的25％）进行了筛查和基线ALT 1.3到2 x ULN。分别在60％和72％的乙型肝炎e抗原（HBeAg）阳性和HBeAg阴性的患者中观察到临床上显着的坏死性炎症（Knodell坏死性炎症评分>或= 7），而明显的纤维化（Ishak纤维化评分>或= 4） HBeAg阳性和HBeAg阴性患者分别观察到8％和15％。在恩替卡韦治疗的HBeAg阴性患者中，组织学改善，HBV DNA <300拷贝/ mL和ALT正常化的患者比例在轻度升高的ALT患者和ALT> 2 x ULN的患者中相似。但是，与ALT大于2 x ULN的患者相比，恩替卡韦治疗的ALT轻度升高的HBeAg阳性患者的组织学改善，HBV DNA低于300拷贝/ mL，ALT正常化和HBeAg血清转化的应答率较低。结论：这项回顾性分析表明，恩替卡韦治疗的HBeAg阴性CHB患者的反应相似，而与基线ALT水平无关。但是，ALT轻度升高的HBeAg阳性患者对恩替卡韦的治疗效果不如ALT大于2 x ULN的患者。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号