肝内乙肝病毒DNA作为HBeAg阳性慢性乙型肝炎患者抗病毒治疗疗效的预测指标
Intrahepatic HBV DNA as a predictor of antivirus treatment efficacy in HBeAg-positive chronic hepatitis B patients.
作者信息
Lu Hai-Ying, Zhuang Li-Wei, Yu Yan-Yan, Ivan Hadad, Si Chong-Wen, Zeng Zheng, Li Jun, Hou Dong-Ming, Chen Xin-Yue, Han Zhong-Hou, Chen Yong
机构信息
Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China.
出版信息
World J Gastroenterol. 2007 May 28;13(20):2878-82. doi: 10.3748/wjg.v13.i20.2878.
AIM
To evaluate the effect of antiviral agents on intrahepatic HBV DNA in HBeAg-positive chronic hepatitis B patients.
METHODS
Seventy-one patients received treatment with lamivudine, interferon alpha (IFN-alpha 2b) or sequential therapy with lamivudine-IFN-alpha 2b for 48 wk. All subjects were followed up for 24 wk. Serum and intrahepatic HBV DNA were measured quantitatively by PCR. HBV genotypes were analyzed by PCR-RFLP.
RESULTS
At the end of treatment, the intrahepatic HBV DNA level in 71 patients decreased from a mean of (6.1 +/- 1.0) log10 to (4.9 +/- 1.4) log10. Further, a larger decrease was seen in the intrahepatic HBV DNA level in patients with HBeAg seroconversion. Intrahepatic HBV DNA level (before and after treatment) was not significantly affected by the patients' HBV genotype, or by the probability of virological flare after treatment.
CONCLUSION
Intrahepatic HBV DNA can be effectively lowered by antiviral agents and is a significant marker for monitoring antivirus treatment. Low intrahepatic HBV DNA level may achieve better efficacy of antivirus treatment.
目的
评估抗病毒药物对HBeAg阳性慢性乙型肝炎患者肝内乙肝病毒（HBV）DNA的影响。
方法
71例患者接受拉米夫定、α干扰素（IFN-α 2b）治疗或拉米夫定 - IFN-α 2b序贯治疗48周。所有受试者随访24周。采用聚合酶链反应（PCR）法定量检测血清和肝内HBV DNA。通过PCR - 限制性片段长度多态性（RFLP）分析HBV基因型。
结果
治疗结束时，71例患者肝内HBV DNA水平从平均（6.1±1.0）log10降至（4.9±1.4）log10。此外，HBeAg血清学转换患者的肝内HBV DNA水平下降幅度更大。患者HBV基因型以及治疗后病毒学突破的可能性对肝内HBV DNA水平（治疗前后）无显著影响。
结论
抗病毒药物可有效降低肝内HBV DNA水平，且是监测抗病毒治疗的重要指标。肝内HBV DNA水平低可能使抗病毒治疗获得更好疗效。
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