Gish R G, Lau J Y, Brooks L, Fang J W, Steady S L, Imperial J C, Garcia-Kennedy R, Esquivel C O, Keeffe E B
Department of Transplantation, California Pacific Medical Center, San Francisco, USA.
Hepatology. 1996 Jan;23(1):1-7. doi: 10.1002/hep.510230101.
To determine the safety and efficacy of ganciclovir treatment of hepatitis B virus (HBV) infection after liver transplantation, nine patients (seven males, two females; mean age, 38 years) with posttransplant HBV infection were treated with ganciclovir for 3 to 10 months. Ganciclovir was administered intravenously at an initial dose of 5 mg/kg/d and then increased to 10 mg/kg/d. Immunosuppressive drug therapy was maintained at low levels. There were no major side effects of ganciclovir therapy. Serum HBV DNA levels decreased by a mean of 90% (range, 42% to 100%), and four of nine patients had no measurable HBV DNA at the completion of therapy. Mean serum alanine aminotransferase levels decreased by 83%. Hepatic expression of HBV antigens and HBV DNA was assessed before and after therapy in six patients and found to be reduced in three patients. The histology activity index was also stabilized or improved in all patients. After discontinuation of therapy, four of nine patients underwent retreatment for 4- to 12-fold elevation of serum HBV DNA and/or biochemical and clinical relapse, that was severe in one patient. This pilot study shows the safety and efficacy of ganciclovir therapy for reducing HBV replication in patients with HBV infection after liver transplantation.
为确定更昔洛韦治疗肝移植后乙型肝炎病毒（HBV）感染的安全性和疗效，对9例肝移植后HBV感染患者（7例男性，2例女性；平均年龄38岁）使用更昔洛韦治疗3至10个月。更昔洛韦静脉给药，初始剂量为5mg/kg/d，然后增至10mg/kg/d。免疫抑制药物治疗维持在低水平。更昔洛韦治疗未出现严重副作用。血清HBV DNA水平平均下降90%（范围为42%至100%），9例患者中有4例在治疗结束时检测不到HBV DNA。血清丙氨酸氨基转移酶平均水平下降83%。对6例患者治疗前后的肝组织HBV抗原和HBV DNA表达进行评估，发现3例患者表达降低。所有患者的组织学活动指数也保持稳定或有所改善。停药后，9例患者中有4例因血清HBV DNA升高4至12倍和/或生化及临床复发而接受再次治疗，其中1例患者病情严重。这项初步研究表明，更昔洛韦治疗可安全有效地降低肝移植后HBV感染患者的HBV复制。
