替诺福韦挽救治疗耐药复发的慢性乙型肝炎患者48周疗效初探
发布时间：2019-05-18 12:05
【摘要】：目的观察替诺福韦(TDF)单药或联合恩替卡韦(ETV)挽救治疗耐药复发的慢性乙型肝炎患者的疗效及安全性。方法回顾性分析11例耐药复发的慢性乙型肝炎患者的挽救治疗,其中6例患者单用TDF,5例患者采用TDF联合ETV。采用时间分辨免疫荧光法检测血清乙型肝炎病毒标志物,采用脱氧核糖核酸测序法检测与耐药相关的HBV P区169、173、180、181、184、202、204、233、236、250位耐药变异,采用PCR-荧光探针法检测血清HBV DNA载量,采用苦味酸法检测血清肌酐(Cr)水平。应用Kaplan-Meier分析血清HBV DNA累积不可检出率。结果挽救治疗前,1例患者检测到ADV基因型耐药,7例患者检测到LAM/ETV基因型耐药,3例患者检测到LAM/ETV/ADA基因型耐药;HBV DNA基线水平为(4.82±1.29)lg IU/ml,挽救治疗第4周降至(3.57±0.55)lg IU/ml,第12周降至(2.91±0.37)lg IU/ml,随访至第48周,仅1例患者可检测出HBV DNA。挽救治疗4、12、24和36周,血清HBV DNA累积不可检出率分别为36.4%(4/11)、63.6%(7/11)、81.8%(9/11)和90.9%(10/11);随访结束时,血清ALT水平由(64.36±34.55)U/L降至(37.7±24.49)U/L;治疗期间未发生肾功能异常或其他不良事件。结论TDF单药或联合ETV挽救治疗耐药复发的慢性乙型肝炎患者仍能较快速地抑制病毒复制,具有良好的疗效和安全性。
[Abstract]:Objective to observe the efficacy and safety of tenofovir (TDF) alone or entecavir (ETV) in the treatment of drug-resistant recurrent chronic hepatitis B. Methods the rescue treatment of 11 patients with drug resistance recurrence of chronic hepatitis B was analyzed retrospectively. among them, 6 patients were treated with TDF,5 alone with TDF combined with ETV.. Serum hepatitis B virus markers were detected by time-resolved immunofluorescence, HBV P region 16917318018181820204233236250 mutation related to drug resistance was detected by deoxyribonucleic acid sequencing, and serum HBV DNA load was detected by PCR- fluorescence probe method. Serum creatinine (Cr) level was measured by picric acid method. The cumulative undetected rate of serum HBV DNA was analyzed by Kaplan-Meier. Results before rescue treatment, ADV genotypic resistance was detected in 1 patient, LAM/ETV genotypic resistance was detected in 7 patients, and LAM/ETV/ADA genotypic resistance was detected in 3 patients. The baseline level of HBV DNA decreased from (4.82 卤1.29) lg IU/ml, to (3.57 卤0.55) lg IU/ml, at the 12th week to (2.91 卤0.37) lg IU/ml, at the 12th week. HBV DNA. could be detected in only one patient. After 4, 12, 24 and 36 weeks of rescue treatment, the cumulative undetected rate of serum HBV DNA was 36.4% (4 鈮，
本文编号：2479980
[Abstract]:Objective to observe the efficacy and safety of tenofovir (TDF) alone or entecavir (ETV) in the treatment of drug-resistant recurrent chronic hepatitis B. Methods the rescue treatment of 11 patients with drug resistance recurrence of chronic hepatitis B was analyzed retrospectively. among them, 6 patients were treated with TDF,5 alone with TDF combined with ETV.. Serum hepatitis B virus markers were detected by time-resolved immunofluorescence, HBV P region 16917318018181820204233236250 mutation related to drug resistance was detected by deoxyribonucleic acid sequencing, and serum HBV DNA load was detected by PCR- fluorescence probe method. Serum creatinine (Cr) level was measured by picric acid method. The cumulative undetected rate of serum HBV DNA was analyzed by Kaplan-Meier. Results before rescue treatment, ADV genotypic resistance was detected in 1 patient, LAM/ETV genotypic resistance was detected in 7 patients, and LAM/ETV/ADA genotypic resistance was detected in 3 patients. The baseline level of HBV DNA decreased from (4.82 卤1.29) lg IU/ml, to (3.57 卤0.55) lg IU/ml, at the 12th week to (2.91 卤0.37) lg IU/ml, at the 12th week. HBV DNA. could be detected in only one patient. After 4, 12, 24 and 36 weeks of rescue treatment, the cumulative undetected rate of serum HBV DNA was 36.4% (4 鈮，
本文编号：2479980
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