Angus P, Richards M, Bowden S, Ireton J, Sinclair R, Jones R, Locarnini S
Liver Transplant Unit, Austin Hospital, Melbourne, Victoria, Australia.
J Gastroenterol Hepatol. 1993 Jul-Aug;8(4):353-7. doi: 10.1111/j.1440-1746.1993.tb01527.x.
The authors have successfully used combination ganciclovir and foscarnet chemotherapy to control viral replication following liver transplantation in a patient with severe recurrence of hepatitis B virus (HBV) infection. The disease was characterized by extremely high viraemias, deteriorating liver function, and high levels of intra-hepatic hepatitis B core antigen (HBcAg) and hepatitis B surface antigen (HBsAg). Treatment resulted in a greater than 30-fold reduction in serum HBV DNA and HBsAg levels. Liver function tests returned to normal and the histological progression of the disease was arrested. Hepatic cytoplasmic HBsAg decreased substantially but there was little change in HBcAg, implicating HBsAg rather than HBcAg in the liver injury. Combination antiviral chemotherapy using agents such as ganciclovir and foscarnet may offer a new approach to the management of post-transplant recurrence of HBV.
作者成功地运用更昔洛韦和膦甲酸联合化疗，控制了一名乙肝病毒（HBV）感染严重复发患者肝移植后的病毒复制。该疾病的特征为极高的病毒血症、肝功能恶化，以及肝内乙肝核心抗原（HBcAg）和乙肝表面抗原（HBsAg）水平升高。治疗使血清HBV DNA和HBsAg水平降低了30倍以上。肝功能检查恢复正常，疾病的组织学进展得以遏制。肝细胞质HBsAg大幅减少，但HBcAg变化不大，这表明肝损伤与HBsAg而非HBcAg有关。使用更昔洛韦和膦甲酸等药物进行联合抗病毒化疗，可能为肝移植后HBV复发的治疗提供一种新方法。
