南方医科大学学报2011，Vol.31Issue(6)：1009-1013,5.
恩替卡韦联合阿德福韦酯对既往核苷类似物治疗失败的慢性乙肝患者疗效分析
Safety and efficacy of Entecavir combined with Adefovir in patients with chronic. hepatitis B who fail to respond to nucleoside analog treatment
摘要
Abstract
Objective To evaluate the safety and efficacy of the combined therapy with entecavir (ETV) and adefovir (ADV) in patients with chronic hepatitis B (CHB) who experienced failure of treatment with single or multiple nudeoside analogs, and analyze the factors that affect the patients' response to the treatment. Methods Forty-five CHB patients who experienced treatment failure with sequential or/and combined nucleoside analogs received the combined therapy with entecavir and adefovir lasting for at least 6 months. The viroloigcal response (VR), biochemical response (BR) and combined response (CR) at 24 and 48 weeks of the treatment were evaluated. Univairante analysis was used to identify the factors that affect the response to the anti-viral therapy. Results The VR, BR and CR were 67.7%, 77.8% and 57.8% at 24 weeks, as compared to 76.2%, 78.6% and 61.9% at 48 weeks, respectively. The VR differed significantly between patients with a baseline HBV DNA level [lg(copies/ml)] of 3-6 and those with a level over 6 (85.2% vs 40%, Z=-4.796, P=0.037) at 48 weeks. The presence and absence of cirrhosis at the initial treatment significantly affected the BR at 24 weeks (17.1% vs 82.9%, P=0.048) and at 48 weeks (23.8% vs 76.2%, P= 0.023). Conclusion Entecavir combined with adefovir is an effective rescue therapy in CHB patients after failure of treatment with nucleoside analogs. Patients with a lower baseline HBV DNA level without cirrhosis may have better response to the combined treatment.关键词
慢性乙型肝炎/核苷(酸)类似物/恩替卡韦/阿德福韦酯Key words
hepatitis B virus/ nucleoside analogs/ entecavir/ adefovir分类
医药卫生引用本文复制引用
阎丽,王战会,杨洁,周彬,郭亚兵,彭劼,孙剑,侯金林..恩替卡韦联合阿德福韦酯对既往核苷类似物治疗失败的慢性乙肝患者疗效分析[J].南方医科大学学报,2011,31(6):1009-1013,5.基金项目
"十一五"国家科技支撑计划(2008ZX10002-004) （2008ZX10002-004）
