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乙肝病毒B/C基因型与拉米夫定治疗反应:一项系统评价

HBV genotype B/C and response to lamivudine therapy: a systematic review.

作者信息

Chen Xiu-Li, Li Man, Zhang Xiao-Lan

机构信息

Department of Gastroenterology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Gastroenterology, Hebei Institute of Gastroenterology, No. 215 Heping West Road, Shijiazhuang 050000, China.

Department of Epidemiology, School of Public Health, Hebei Medical University, Shijiazhuang, Hebei 050017, China.

出版信息

Biomed Res Int. 2013;2013:672614. doi: 10.1155/2013/672614. Epub 2013 Nov 19.

DOI:10.1155/2013/672614
PMID:24364035
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3863712/
Abstract

A number of nucleoside analogues such as lamivudine (LAM), actually used for the treatment of chronic hepatitis B, can suppress HBV DNA replication, improve transaminase level and liver histology, and enhance the rate of hepatitis B e antigen (HBeAg) clearance. The responses to LAM therapy involve HBeAg clearance and HBV DNA conversion of negative. However, the associations between HBV genotype B/C and response to LAM therapy remain ambiguous. The aim of this meta-analysis is to determine more precise estimations of the relationship. All the publications on the associations between HBV genotype B/C and response to LAM (HBeAg clearance and HBV DNA conversion of negative) through June 2013 were collected. Relative risk (RR) with 95% confidence intervals (95% CI) was calculated in fixed or random model, I² was calculated to examine heterogeneity, and funnel plots were plotted to examine small study effects with Stata 11 software. Overall, for HBeAg clearance and genotype B/C, the RR (95% CI) was 1.27 (0.94-1.71), while for HBV DNA conversion of negative and genotype B/C, the RR (95% CI) was 1.07 (0.98-1.17). HBV genotype B/C shows no significance associations with response to lamivudine therapy (HBeAg clearance and HBV DNA conversion of negative).

摘要

一些核苷类似物,如拉米夫定(LAM),实际上用于治疗慢性乙型肝炎,可抑制乙肝病毒(HBV)DNA复制,改善转氨酶水平和肝脏组织学,并提高乙肝e抗原(HBeAg)清除率。拉米夫定治疗的反应包括HBeAg清除和HBV DNA转阴。然而,HBV B/C基因型与拉米夫定治疗反应之间的关联仍不明确。本荟萃分析的目的是更精确地确定这种关系。收集了截至2013年6月所有关于HBV B/C基因型与拉米夫定治疗反应(HBeAg清除和HBV DNA转阴)之间关联的出版物。使用固定或随机模型计算相对风险(RR)及95%置信区间(95%CI),计算I²以检验异质性,并使用Stata 11软件绘制漏斗图以检验小研究效应。总体而言,对于HBeAg清除和B/C基因型,RR(95%CI)为1.27(0.94 - 1.71),而对于HBV DNA转阴和B/C基因型,RR(95%CI)为1.07(0.98 - 1.17)。HBV B/C基因型与拉米夫定治疗反应(HBeAg清除和HBV DNA转阴)无显著关联。

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本文引用的文献

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Molecular epidemical characteristics of Lamivudine resistance mutations of HBV in southern China.中国南方地区乙型肝炎病毒拉米夫定耐药突变的分子流行特征。
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Monotherapy versus combination therapy for the treatment of chronic hepatitis B.单药治疗与联合治疗慢性乙型肝炎。
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Tenofovir disoproxil fumarate is superior to lamivudine plus adefovir in lamivudine-resistant chronic hepatitis B patients.替诺福韦酯在拉米夫定耐药的慢性乙型肝炎患者中优于拉米夫定联合阿德福韦酯。
World J Gastroenterol. 2015 Mar 7;21(9):2746-53. doi: 10.3748/wjg.v21.i9.2746.
亚洲慢性乙型肝炎 HBeAg 阳性和 HBeAg 阴性患者接受聚乙二醇干扰素 alfa-2a(40kD)联合或不联合拉米夫定治疗的持续应答。
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Frequent detection of hepatitis B virus variants associated with lamivudine resistance in treated South African patients infected chronically with different HBV genotypes.在南非接受治疗的慢性感染不同乙肝病毒(HBV)基因型的患者中频繁检测到与拉米夫定耐药相关的乙肝病毒变异体。
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[Effects of antiviral agents on intrahepatic ccc DNA in HBeAg-positive chronic hepatitis B patients].[抗病毒药物对HBeAg阳性慢性乙型肝炎患者肝内cccDNA的影响]
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