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[阿德福韦酯治疗慢性乙型肝炎患者中HBeAg血清学转换与基因型及HBV特异性CTL的关系]

[Relationship between HBeAg seroconversion with genotypes and HBV specific CTL in patients with chronic hepatitis B treated with Adefovir dipivoxil].

作者信息

Zhou Yu-Lin, Wang Xue-Cai, Wu Yin-Tao, Tan Yong-Fei, Zhao Yan-Ping, Tang Jun-Ming, Pan Jian-Qiang, Yang Zhi-Xian, Gu Xi-Bing

机构信息

Dept. of Infection, Yixing People's Hospital, Yixing 214200, China.

出版信息

Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2011 Jun;25(3):220-3.

Abstract

OBJECTIVE

To explore relationship between HBeAg seroconversion with HBV genotypes and HBV specific CTL in patients with chronic hepatitis B (CHB) treated with Adefovir dipivoxil.

METHODS

Seventy CHB patients had positive HBV DNA (HBV DNA > or = 1 x 10(4) copy/ml), 45 cases had positive HBeAg, of whom 23 cases (51. 11%) had genotype B, 22 cases (48.89%) had genotype C. ALT > 2 x upper limit of normal value (ULN), human leukocyte antigen (HLA)-A(n) positive, patients were treated with Adefovir dipivoxil (commercial name is Mingzheng, Zhengda Tianjing Pharmaceutical Company), 10 mg, orally, once a day. After treatment for 12 months, observe relationship between HBeAg seroconversion with HBV genotypes and HBV specific CTL.

RESULTS

After treatment with Adefovir dipivoxil for 12 months, HBV specific CTL (0.68% +/- 0.11%) was higher than that before treatment (0.33% +/- 0.11%), t = 8.36 P < 0.001, HBV DNA (3.01 +/- 0.2) log10 copy/ml was lower than that before treatment (6.27 +/- 0.70) log10 copy/ml, t = 12.63 P < 0.001, HBV DNA turned negative (< 500 copy/ml) 43 cases (61.43%), in 45 cases with positive HBeAg, HBeAg turned negative in 13 cases (28.89%), 8 cases had HBeAg seroconversion (17.78%), HBV specific CTL (0.86% +/- 0.05%) of patients with HBeAg seroconversion is higher than (0.61% +/- 0.07%) of patients without HBeAg seroconversion (37 cases, 82.22%) t = 7.88, P < 0.001. In 8 cases with HBeAg seroconversion, 7 cases had genotype B (30.43% of genotype B), 1 cases had genotype C (4.55% of genotype C), chi2 = 5.15, P < 0.05.

CONCLUSION

Adefovir dipivoxil can enhance HBV specific cellular immunity of CHB patients. After treatment, occurrence of HBeAg seroconversion is related to increase of HBV specific CTL level and may be related to genotypes.

摘要

目的

探讨阿德福韦酯治疗慢性乙型肝炎(CHB)患者时HBeAg血清学转换与HBV基因型及HBV特异性CTL之间的关系。

方法

70例CHB患者HBV DNA阳性(HBV DNA≥1×10⁴拷贝/ml),45例HBeAg阳性,其中23例(51.11%)为B基因型,22例(48.89%)为C基因型。ALT>2倍正常上限值(ULN),人类白细胞抗原(HLA)-A(n)阳性,患者接受阿德福韦酯(商品名明正,正大天晴药业公司)治疗,10mg,口服,每日1次。治疗12个月后,观察HBeAg血清学转换与HBV基因型及HBV特异性CTL之间的关系。

结果

阿德福韦酯治疗12个月后,HBV特异性CTL(0.68%±0.11%)高于治疗前(0.33%±0.11%),t = 8.36,P<0.001;HBV DNA(3.01±0.2)log₁₀拷贝/ml低于治疗前(6.27±0.70)log₁₀拷贝/ml,t = 12.63,P<0.001;43例(61.43%)HBV DNA转阴(<500拷贝/ml)。45例HBeAg阳性患者中,13例(28.89%)HBeAg转阴,8例(17.78%)发生HBeAg血清学转换。发生HBeAg血清学转换患者的HBV特异性CTL(0.86%±0.05%)高于未发生HBeAg血清学转换患者(37例,82.22%)的(0.61%±0.07%),t = 7.88,P<0.001。8例发生HBeAg血清学转换的患者中,7例为B基因型(占B基因型的30.43%),1例为C基因型(占C基因型的4.55%),χ² = 5.15,P<0.05。

结论

阿德福韦酯可增强CHB患者的HBV特异性细胞免疫。治疗后HBeAg血清学转换的发生与HBV特异性CTL水平升高有关,且可能与基因型有关。

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