替比夫定对慢性乙型肝炎HBeAg作用的有关因素探讨

Investigation of Relevant Influential Factors of HBeAg Quantitation with Telbivudine Treatment on Chronic Hepatitis B Patients

关键词:  替比夫定  慢性乙型肝炎  乙肝病毒  核糖核酸  乙肝e抗原

Key words:  telbivudine  chronic hepatitis B  hepatitis B virus  ribonucleic acid  HBeAg

摘要:

目的 探讨替比夫定治疗HBeAg阳性慢性乙型肝炎对HBeAg作用的影响因素。方法 采用替比夫定治疗124例HBeAg阳性慢性乙型肝炎48周，观察患者ALT、HBV DNA、HBeAg治疗前后变化，分析治疗前基线HBV DNA载量、ALT水平，治疗期间不同时限HBV DNA降至低于检测限对替比夫定治疗48周时HBeAg的影响。结果 治疗48周时HBV DNA阴转103例(83.1%)，ALT恢复正常122例(98.4%)，HBeAg阴转45例(36.2%)，HBeAg转换32例(25.8%)。治疗前基线HBV DNA载量、ALT水平对治疗48周时 HBeAg的定量及阴转改变有影响，48周时 HBeAg阴转率分别如下：治疗前HBV DNA<107 Coples·mL^-1组为47.3%，≥107 Coples·mL^-1组为27.5%，ALT≥200 U·L^-1组为58.5%，<200 U·L^-1组为19.7%。治疗中HBV DNA不同时限降至低于检测限对48周时降低HBeAg定量及阴转有显著影响，HBeAg阴转率分别如下：HBV DNA<12周内阴转组为53.8%，12~24周内阴转组为37.1%，>24周内阴转组为25%。结论 治疗前基线HBV DNA载量、ALT水平及治疗中HBV DNA不同时限降至检测限以下对治疗48周时替比夫定对HBeAg作用有明显的影响。

Abstract:

OBJECTIVE To investigate the influential factors of HBeAg quantitation with telbivudine treatment on HBeAg-positive patients with chronic hepatitis B. METHODS Totally 124 HBeAg-positive patients with chronic hepatitis B were therapied with telbivudine for 48 weeks. Observed the change of ALT levels, HBV DNA load and HBeAg quantitation before and after the treatment, and analyzed the influences of baseline HBV DNA load before treatment, ALT levels，and different phases of HBV DNA undetectable during the treatment to HBeAg quantitation with telbivudine treatment on HBeAg-positive patients for 48 weeks. RESULTS The number of HBV DNA undetectable was 103(83.1%), the number of ALT normalization was 122(98.4%), the number of HBeAg undetectable was 45(36.2%), and the number of HBeAg seroconversion was 32(25.8%) after treatment for 48 weeks. Baseline HBV DNA load before treatment and ALT levels had influence on HBeAg quantitation and the rate of HBeAg undetectable. The rate of HBeAg undetectable was 47.3% in HBV DNA<107 Coples·mL^-1 group and 27.5% in HBV DNA≥107 Coples·mL^-1 group after treated with telbivudine for 48 weeks; the rate of HBeAg undetectable was 58.5% and 19.7% in ALT≥200 U·L^-1 group and ALT<200 U·L^-1 group after treated with telbivudine for 48 weeks. Different phases of HBV DNA undetectable during treatment had significant influence on degrading HBeAg quantitation and the rate of HBeAg undetectable after treated with telbivudine for 48 weeks. The rate of HBeAg undetectable was 53.8% in the group which the time of HBeAg undetectable was less than 12 weeks, the rate of HBeAg undetectable was 37.1% in the group which the time of HBeAg undetectable between 12 and 24 weeks, and the rate of HBeAg undetectable was 25% in the group which the time of HBeAg undetectable was more than 24 weeks. CONCLUSION Baseline HBV DNA load before treatment, ALT levels, and different phases of HBV DNA undetectable have significant influences on HBeAg quantitation after treatment with telbivudine for 48 weeks.