Benhamou Y, Katlama C, Lunel F, Coutellier A, Dohin E, Hamm N, Tubiana R, Herson S, Poynard T, Opolon P
Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Ann Intern Med. 1996 Nov 1;125(9):705-12. doi: 10.7326/0003-4819-125-9-199611010-00001.
Therapy for hepatitis B virus (HBV) infection is still unsatisfactory, particularly in patients who are co-infected with the human immunodeficiency virus (HIV). Lamivudine, a retroviral inhibitor, has been shown to have activity against HBV replication in vitro, in animal models, and in studies of immunocompetent persons.
To assess the efficacy of lamivudine in inhibiting HBV replication during a 12-month period in patients with both HBV and HIV infection.
Prospective, open study.
University hospital.
40 consecutive patients (39 men and 1 woman) infected with both HIV and HBV. All had progressive HIV disease; were refractory to or unable to tolerate therapies other than lamivudine; and received lamlvudine, 600 mg/d or 600 mg/d followed by 300 mg/d, as therapy for HIV disease.
Serum concentrations of HBV DNA were assessed every 2 months by using molecular hybridization. Polymerase chain reaction (PCR) for HBV DNA was done at baseline and was done at months 2, 6, and 12 only if the HBV DNA concentration was less than 5 pg/mL.
Two groups were retrospectively identified at baseline: patients with high HBV replication (serum HBV DNA concentrations > 5 pg/mL) (n = 30) and patients with low HBV replication (serum HBV DNA concentrations < 5 pg/mL) (n = 10). After 12 months of treatment, 26 of 27 patients (96.3% [95% Cl, 81% to 99.9%]) who had had high HBV replication at baseline had serum HBV DNA concentrations less than 5 pg/mL. However, PCR could still detect HBV DNA in serum in 11.5% (Cl, 2% to 30%) of these patients. Among patients who had had low HBV replication at baseline, the results of PCR for serum HBV DNA became negative in the 6 patients who had had a positive result on PCR at baseline. No serious adverse events occurred during treatment.
Although this study was not a randomized, blinded trial, it suggests that lamivudine is active against.
乙型肝炎病毒（HBV）感染的治疗仍不尽人意，尤其是在合并人类免疫缺陷病毒（HIV）感染的患者中。拉米夫定是一种逆转录病毒抑制剂，已在体外、动物模型以及免疫功能正常者的研究中显示出对HBV复制有活性。
评估拉米夫定在12个月期间对HBV和HIV合并感染患者抑制HBV复制的疗效。
前瞻性、开放性研究。
大学医院。
40例连续的同时感染HIV和HBV的患者（39例男性和1例女性）。所有患者均患有进展性HIV疾病；对拉米夫定以外的治疗难治或无法耐受；并接受拉米夫定，600mg/d或600mg/d后改为300mg/d，作为HIV疾病的治疗。
每2个月使用分子杂交法评估血清HBV DNA浓度。HBV DNA的聚合酶链反应（PCR）在基线时进行，仅当HBV DNA浓度低于5pg/mL时，在第2、6和12个月进行。
在基线时回顾性确定了两组：高HBV复制患者（血清HBV DNA浓度>5pg/mL）（n = 30）和低HBV复制患者（血清HBV DNA浓度<5pg/mL）（n = 10）。治疗12个月后，基线时高HBV复制的27例患者中有26例（96.3%[95%CI，81%至99.9%]）血清HBV DNA浓度低于5pg/mL。然而，PCR仍能在这些患者的11.5%（CI，2%至30%）血清中检测到HBV DNA。在基线时低HBV复制的患者中，基线时PCR结果为阳性的6例患者血清HBV DNA的PCR结果变为阴性。治疗期间未发生严重不良事件。
尽管本研究不是随机、盲法试验，但提示拉米夫定对……有活性。
