Hurwitz S J, Tennant B C, Korba B E, Gerin J L, Schinazi R F
Laboratory of Biochemical Pharmacology, Department of Pediatrics, Emory University School of Medicine and Veterans Affairs Medical Center, Decatur, Georgia 30033, USA.
Antimicrob Agents Chemother. 1998 Nov;42(11):2804-9. doi: 10.1128/AAC.42.11.2804.
The pharmacodynamics of (-)-beta-2',3'-dideoxy-3'-thiacytidine (3TC) was studied in chronically woodchuck hepatitis virus-infected woodchucks and compared to that in previous studies in hepatitis B virus (HBV)-infected humans. Net depletion rates of serum virus DNA in woodchucks receiving 3TC were modeled as a sum of an exponentially declining virus input and a first-order elimination. Preceding shoulders and pseudo-first-order virus half-lives in serum ranged from 1 to 7 days and were dose dependent. Higher plasma 3TC concentrations were needed in woodchucks for virus depletion similar to that attained in humans. Human HBV depletion curves from a previous clinical study with 3TC (>/=100 mg per day) were described by a biexponential relationship. The average half-life value in humans, normalized to fraction of area under the serum virus load-time curve, was similar to the average half-life value observed in woodchucks given the highest 3TC dose (2.4 and 2.0 days, respectively). On cessation of therapy, virus load rebounds in woodchucks were dose dependent and resembled posttherapy virus "flares" reported to occur in humans. The estimates of drug exposures that could lead to optimal antiviral effects presented indicate that 3TC should not be underdosed and compliance should be monitored. The study of chronically infected woodchucks may prove useful for optimizing drug regimens for hepadnavirus infections.
对慢性土拨鼠肝炎病毒感染的土拨鼠进行了(-)-β-2',3'-二脱氧-3'-硫代胞苷(3TC)的药效学研究,并与先前在乙型肝炎病毒(HBV)感染的人类中的研究结果进行了比较。接受3TC的土拨鼠血清病毒DNA的净消耗率被模拟为指数下降的病毒输入和一级消除的总和。血清中先前的肩部和伪一级病毒半衰期为1至7天,且呈剂量依赖性。土拨鼠需要更高的血浆3TC浓度才能实现与人类相似的病毒消耗。先前一项3TC(每天≥100mg)临床研究中的人类HBV消耗曲线可用双指数关系描述。根据血清病毒载量-时间曲线下面积的分数进行归一化后,人类的平均半衰期值与给予最高3TC剂量的土拨鼠中观察到的平均半衰期值相似(分别为2.4天和2.0天)。治疗停止后,土拨鼠中的病毒载量反弹呈剂量依赖性且类似于据报道在人类中发生的治疗后病毒“爆发”。本研究提出的可能导致最佳抗病毒效果的药物暴露估计表明,3TC不应剂量不足,应监测依从性。对慢性感染土拨鼠的研究可能证明有助于优化嗜肝DNA病毒感染药物方案。