라미부딘 내성 만성 B형 간염환자에서 아데포비어 장기 치료 성적- HBeAg 양성군과 음성군의 비교 - : The Long Term Outcome of Lamivudine-Resistant Chronic Hepatitis B Treated with Adefovir -Comparison between HBeAg Positive and Negative Patients-
- 발행기관 고려대학교
- 발행년도 2007
- 학위수여년월 2007. 2
- 학위명 석사
- 학과 대학원 의학과 내과학전공
- 식별자(기타) DL:000018551250
- 서지제어번호 000045344429
초록/요약
Background and Aim: Adefovir dipivoxil (adefovir) provides effective antiviral therapy in patients with chronic hepatitis B, but the emergence of the mutation is known to be associated with reduced efficacy to drug treatment. The aim of this study is to evaluate the long term outcome of adefovir therapy in lamivudine-resistant chronic hepatitis B patients, such as virologic response, virologic and biochemical breakthrough, and the emergence of resistance, according to the pre-treatment HBeAg status. Material and Method: We enrolled the 204 patients who were lamivudine-resistant and received adefovir treatment more than 6 months. Serum HBV DNA level was qualified by real time PCR. Biochemical and virologic parameters such as HBeAg, anti-HBe, and serum HBV DNA level were monitored every 2~3 months. Results: The baseline serum HBV DNA level was significantly lower in HBeAg (-) group (p=0.001), but serum ALT level was not so different. IVR was much higher among HBeAg (-) group (p=0.003) and cumulative V-BT rate was significantly lower among HBeAg (+) group (p=0.047), but ALP normalization rate, decrease of serum HBV DNA log copies, & B-BT rate, resistance rate and type of resistance were not significantly different between HBeAg (+) and (-) groups. Conclusions: We should attention to the emergence of adefovir resistance and acute exacerbation of chronic hepatitis B when treat lamivudine resistant patients with adefovir for long term period, especially when pre-treatment HBeAg (+).
more초록/요약
Background and Aim: Adefovir dipivoxil (adefovir) provides effective antiviral therapy in patients with chronic hepatitis B, but the emergence of the mutation is known to be associated with reduced efficacy to drug treatment. The aim of this study is to evaluate the long term outcome of adefovir therapy in lamivudine-resistant chronic hepatitis B patients, such as virologic response, virologic and biochemical breakthrough, and the emergence of resistance, according to the pre-treatment HBeAg status. Material and Method: We enrolled the 204 patients who were lamivudine-resistant and received adefovir treatment more than 6 months. Serum HBV DNA level was qualified by real time PCR. Biochemical and virologic parameters such as HBeAg, anti-HBe, and serum HBV DNA level were monitored every 2~3 months. Results: The baseline serum HBV DNA level was significantly lower in HBeAg (-) group (p=0.001), but serum ALT level was not so different. IVR was much higher among HBeAg (-) group (p=0.003) and cumulative V-BT rate was significantly lower among HBeAg (+) group (p=0.047), but ALP normalization rate, decrease of serum HBV DNA log copies, & B-BT rate, resistance rate and type of resistance were not significantly different between HBeAg (+) and (-) groups. Conclusions: We should attention to the emergence of adefovir resistance and acute exacerbation of chronic hepatitis B when treat lamivudine resistant patients with adefovir for long term period, especially when pre-treatment HBeAg (+).
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