Ristig Maria B, Crippin Jeffrey, Aberg Judith A, Powderly William G, Lisker-Melman Mauricio, Kessels Lisa, Tebas Pablo
Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri 63108, USA.
J Infect Dis. 2002 Dec 15;186(12):1844-7. doi: 10.1086/345770. Epub 2002 Nov 22.
A significant proportion of human immunodeficiency virus (HIV) infected patients are coinfected with hepatitis B virus (HBV). Currently available treatments for chronic hepatitis B (interferon [IFN]-alpha and lamivudine [3TC]) have limited long-term utility because of side effects or of the development of resistance. Tenofovir disoproxil fumarate (TDF) is a nucleotide analog with excellent activity in vitro against HBV, which is also active against 3TC-resistant HBV variants. In this 24-week pilot study, the anti-HBV activity of TDF was prospectively evaluated in a cohort of 6 HIV coinfected subjects for whom 3TC and IFN therapy had previously failed. At baseline, all patients were taking 3TC or FTC and were hepatitis B surface antigen and hepatitis B e antigen positive; 4 had cirrhosis. Baseline HBV load was 7.95 log(10) copies/mL. By weeks 12 and 24, HBV load had decreased by 3.1 log(10) copies/mL and 4.3 log(10) copies/mL, respectively. There was a transient increase of transaminases after the initiation of treatment. No patient developed HBe antibodies. TDF is a very promising drug for the treatment of chronic hepatitis B in HIV-infected individuals.
相当一部分人类免疫缺陷病毒（HIV）感染患者同时感染了乙型肝炎病毒（HBV）。目前用于慢性乙型肝炎的治疗方法（干扰素[IFN]-α和拉米夫定[3TC]）由于副作用或耐药性的产生，长期效用有限。替诺福韦酯（TDF）是一种核苷酸类似物，在体外对HBV具有优异的活性，对3TC耐药的HBV变异体也有活性。在这项为期24周的初步研究中，对6名先前3TC和IFN治疗失败的HIV合并感染受试者组成的队列进行了TDF抗HBV活性的前瞻性评估。基线时，所有患者均服用3TC或FTC，乙肝表面抗原和乙肝e抗原呈阳性；4例有肝硬化。基线HBV载量为7.95 log(10)拷贝/mL。到第12周和24周时，HBV载量分别下降了3.1 log(10)拷贝/mL和4.3 log(10)拷贝/mL。治疗开始后转氨酶有短暂升高。没有患者产生HBe抗体。TDF是治疗HIV感染个体慢性乙型肝炎的一种非常有前景的药物。
