初治慢性乙型肝炎患者应用克来夫定的疗效。
Efficacy of initial treatment with clevudine in naive patients with chronic hepatitis B.
机构信息
Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
出版信息
Korean J Intern Med. 2010 Dec;25(4):372-6. doi: 10.3904/kjim.2010.25.4.372. Epub 2010 Nov 27.
BACKGROUND/AIMS: Clevudine, a pyrimidine nucleoside analogue, has potent antiviral effects in patients with chronic viral hepatitis B (CHB). We report the efficacy of initial treatment with clevudine in naïve patients with CHB living in Daejeon and Chungcheong Province, South Korea.
METHODS
One hundred five adults with CHB were administered 30 mg of clevudine per day for an average of 51 weeks. We evaluated viral markers and liver biochemistry retrospectively every 3 months.
RESULTS
Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and hepatitis B virus (HBV) DNA before the treatment were 184 ± 188 IU/L, 150 ± 138 IU/L, and 7.1 ± 1.2 log copies/mL, respectively. Undetectable rates (< 60 IU/mL) of DNA were 36.2%, 68.9%, 83.6%, 76.2%, and 75.8% at 12, 24, 36, 48, and 60 weeks, respectively. Seroconversion rates were 9.1%, 13.6%, 24.6%, 26.5%, and 26.1% and ALT normalization rates were 64.5%, 78.1%, 87.9%, 90.0% at 12, 24, 36, and 48 weeks, respectively. Six patients (5.7%) had a viral breakthrough.
CONCLUSIONS
Clevudine is a useful drug in the initial treatment of patients with CHB, with a potent antiviral effect and low incidence of viral breakthrough.
背景/目的：克来夫定是一种嘧啶核苷类似物，对慢性乙型病毒性肝炎（CHB）患者具有强大的抗病毒作用。我们报告了在韩国大田和忠清省接受初始克来夫定治疗的 CHB 初治患者的疗效。
方法
105 例成人 CHB 患者每天接受 30 毫克克来夫定治疗，平均治疗时间为 51 周。我们每 3 个月回顾性评估病毒标志物和肝功能。
结果
治疗前丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）和乙型肝炎病毒（HBV）DNA 分别为 184±188IU/L、150±138IU/L 和 7.1±1.2log 拷贝/mL。治疗 12、24、36、48 和 60 周时，HBV DNA 不可检测率（<60IU/mL）分别为 36.2%、68.9%、83.6%、76.2%和 75.8%。血清学转换率分别为 9.1%、13.6%、24.6%、26.5%和 26.1%，ALT 正常化率分别为 64.5%、78.1%、87.9%、90.0%，治疗 12、24、36 和 48 周时。6 例（5.7%）发生病毒突破。
结论
克来夫定是 CHB 初始治疗的一种有效药物，具有强大的抗病毒作用和低病毒突破发生率。
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