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[拉米夫定治疗对既往α干扰素治疗无反应的慢性乙型肝炎儿童导致HBeAg/抗-HBe血清学转换]

[The HBeAg/antiHBe seroconversion as a result of lamivudine treatment in children with chronic hepatitis B unresponsive to previous interferon alpha therapy].

作者信息

Lebensztejn Dariusz Marek, Skiba Elzbieta, Sobaniec-Lotowska Maria, Kaczmarski Maciej

机构信息

III Klinika Chorób Dzieci AM w Białymstoku.

出版信息

Pol Merkur Lekarski. 2004 Jun;16(96):557-9.

Abstract

UNLABELLED

The aim of the study was evaluation the HBeAg/antiHBe seroconversion frequency as a result of lamivudine treatment in children who are nonresponders to previous IFN-alpha therapy.

MATERIAL AND METHODS

The observation was carried out on 41 children, aged 4-17 years, with biopsy-proven chronic hepatitis B (HBeAg+) treated with lamivudine 3-4 mg/kg/d (max. 100 mg/d) for 12 months.

RESULTS

After 6 months of lamivudine therapy 59.3% children normalized GPT activity and only 1 child (2.5%) lost HBeAg. At the end of 12 months of therapy 81.5% normalized GPT activity and 4 of them (10%) lost HBeAg and seroconverted to antiHBe. None of treated children lost HBsAg. The age, sex, pretreatment GPT activity and active histological disease were not predictors of lamivudine-induced HBeAg loss. There were no side effects of lamivudine therapy except one boy who had severe thrombocytopenia.

CONCLUSIONS

The HBeAg/antiHBe seroconversion rate after one year trial of lamivudine in children with chronic hepatitis B unresponsive to previous IFN alpha therapy was 10%. The age, sex, pretreatment GPT activity and active histologic disease were not predictors of lamivudine-induced HBeAg loss.

摘要

未标记

本研究的目的是评估拉米夫定治疗对先前干扰素-α治疗无反应的儿童中HBeAg/抗HBe血清学转换频率的影响。

材料与方法

对41名4至17岁经活检证实为慢性乙型肝炎(HBeAg阳性)的儿童进行观察,给予拉米夫定3 - 4mg/kg/d(最大100mg/d)治疗12个月。

结果

拉米夫定治疗6个月后,59.3%的儿童谷丙转氨酶(GPT)活性恢复正常,仅1名儿童(2.5%)HBeAg转阴。治疗12个月结束时,81.5%的儿童GPT活性恢复正常,其中4名(10%)HBeAg转阴并血清学转换为抗HBe。所有接受治疗的儿童均未出现HBsAg转阴。年龄、性别、治疗前GPT活性及活动性组织学病变均不是拉米夫定诱导HBeAg转阴的预测因素。除1名男孩出现严重血小板减少外,拉米夫定治疗无其他副作用。

结论

在先前对干扰素-α治疗无反应的慢性乙型肝炎儿童中,拉米夫定治疗1年后HBeAg/抗HBe血清学转换率为10%。年龄、性别、治疗前GPT活性及活动性组织学病变均不是拉米夫定诱导HBeAg转阴的预测因素。

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