拉米夫定耐药的慢性乙型肝炎患者接受单剂量阿德福韦治疗48周:阿德福韦耐药的风险亦增加

作     者：Lee Y.-S. Suh D.J. Lim Y.-S. 王顺涛 

作者机构：Department of Internal MedicineAsan Medical Center388-1Pungnap-dongSongpa-guSeoul138-736South Korea 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2006年第2卷第12期

页      面：46-47页

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：乙型肝炎 耐药突变株 抗病毒 转阴率 阴性患者 耐药者 耐药组 DNA 耐药株 评估依据 

摘      要：Although adefovir dipivoxil(ADV) has a unique profile of delayed and infrequent resistance in treatment-naive chronic hepatitis B patients,the association of ADV resistance with previous lamivudine(LAM) resistance is not well *** compared the emergence of the ADV-resis-tant mutations rtA181V/T and rtN236T between LAM-resistant patients and treatment-naive patients at 48 weeks of ADV ***-seven LAM-resistant patients and 38 treatment-n ve patients were treated with 10 mg/d ADV for more than 48 *** baseline and 48-week blood samples were analyzed for ADV-resistant mutations via restriction fragment mass polymorphism *** responses were evaluated according to changes in serum HBV DNA(measured via real-time polymerase chain reaction) and alanine aminotransferase(ALT) levels and loss of hepatitis B e antigen(HBeAg) .After 48 weeks,10(18%) of the 57 LAM-resistant patients were found to have developed ADV-resistant mutations,whereas none of the 38 treatment-n ve patients developed such mutations(P .05) .In conclusion,the emergence of the rtA181V/T and rtN236T mutations was more common in LAM-resistant patients than in treatment-n ve patients after 48 weeks of ADV therapy and was associated with reduced antiviral efficacy to drug treatment.