Guarascio P, De Felici A P, Migliorini D, Alexander G J, Fagan E A, Visco G
J Hepatol. 1986;3 Suppl 2:S143-7. doi: 10.1016/s0168-8278(86)80113-1.
In a previous study a partial inhibition of viral replication was observed in HBeAg-positive patients after acyclovir (ACV) treatment. To assess those results and to evaluate different treatment regimens, a randomized controlled trial with ACV given at 45 mg/kg/day by continuous infusion (in 5 patients) or by intermittent 8-hourly infusion (in 6 patients) for 28 days versus placebo has been performed in 20 patients affected by chronic hepatitis positive for both HBsAg and HBeAg for at least 6 months. Patients were stratified for sex, presence of cirrhosis and homosexual activity. Modest inhibition of serum DNA polymerase activity was observed after intermittent ACV treatment but not with the continuous infusion. After a 8-12 months follow-up, 2 of 10 of the ACV-treated patients and 3 of the controls had become HBeAg-negative, with 1 and 2 seroconversions to anti-HBe in the treated and placebo group respectively. No adverse effects were observed in ACV-treated patients after continuous infusion, but 2 of 6 patients who received intermittent therapy had to stop treatment, because of abdominal colics and elevation of the serum creatinine. Our data confirm that ACV partially inhibits viral replication in HBeAg-positive patients but without significantly affecting the rate of seroconversion to anti-HBe.
在之前的一项研究中，观察到阿昔洛韦（ACV）治疗后HBeAg阳性患者的病毒复制受到部分抑制。为了评估这些结果并评价不同的治疗方案，对20例HBsAg和HBeAg均阳性至少6个月的慢性肝炎患者进行了一项随机对照试验，将ACV以45mg/kg/天的剂量持续输注（5例患者）或每8小时间歇输注（6例患者）28天，与安慰剂进行对比。患者按性别、是否存在肝硬化和同性恋活动进行分层。间歇ACV治疗后观察到血清DNA聚合酶活性有适度抑制，但持续输注时未观察到。经过8至12个月的随访，ACV治疗的10例患者中有2例和对照组中有3例HBeAg转阴，治疗组和安慰剂组分别有1例和2例血清转换为抗-HBe。持续输注ACV治疗的患者未观察到不良反应，但接受间歇治疗的6例患者中有2例因腹部绞痛和血清肌酐升高而不得不停止治疗。我们的数据证实，ACV可部分抑制HBeAg阳性患者的病毒复制，但对血清转换为抗-HBe的比率无显著影响。
