B型肝炎病毒e抗原效價對慢性B型肝炎病患接受干安能治療反應之影響
The Impact of HBeAg Index Value on the Response to Lamivudine Treatment in Chronic Hepatitis B Patients
Date Issued
2005
Date
2005
Author(s)
Wang, Chia-Chi
DOI
zh-TW
Abstract
Background:
In Asian multi-center research for lamivudine treatment in patients with chronic hepatitis B, HBeAg seroconversion rate was proportional to the duration of lamivudine treatment. The response rate of lamivudine treatment was 17%, 27%, 33% and 47% from one year to four years treatment respectively. The pretreatment ALT level has been noted to be positively correlated with the response of lamivudine treatment. It is not clear whether the titer of HBeAg can predict the outcome of lamivudine treatment?
Aim:
Are pretreated and dynamic change of HBeAg titer associated with the response of lamivudine treatment in chronic hepatitis B patients?
Methods:
Total 49 chronic hepatitis B patients with HBeAg positive and ALT level more than 5 times of normal upper limit without cirrhosis and malignancy were enrolled. They received 100 mg lamivudine every day for at least one year. The response of treatment is defined as normalized ALT level, HBeAg loss or seroconversion and undetectable HBV DNA by traditional hybridization method. According to the response after one year treatment, we separated the persons into two groups: one is response group, another is non-response group. Compare the titer of HBeAg before treatment and the ratio of HBeAg decrease during treatment especially in first three and six months (early HBeAg response) between two groups.
Results:
Total 49 cases were enrolled. The baseline characters as following: male/female=35/14, mean age 31+7.3 year-old, genotype B: genotype C =37:12(75.5%/24.5%), pretreatment ALT value:565.7U/L±433.8, HBeAg index ratio 38.5±41.8(S/N), HBV DNA titer 3.85x109±1.1×1010 copies/ml. Total 24 cases completed one year lamivudine treatment. The male to female ratio was 19/5 . The mean age was 32.9+7.03 year-old. The one year on-therapy response as following: biochemical response 79.2%, serologic response 75%, virologic response 58.3% and combined response 50%. The baseline characters of genotype B infected chronic hepatitis B patients were comparable with those of genotype C infected patients. The HBeAg titer was positively correlated with HBV DNA titer (Pearson correlation coefficient:0.62, P<0.0001). According to the presence of combined response, the characters of responders were comparable with those of non-responder in age, sex, genotype, pretreated ALT value, HBV DNA titer, HBeAg titer, 3rd and 6th early e antigen response and 6th HBeAg rebound.
Discussion and conclusions:
In our study, HBeAg index ratio was positively correlated with HBV DNA titer. Therefore, we could predict the HBV DNA titer by HBeAg index ratio in clinical practice. The HBeAg index ratio and HBV DNA titer were comparable between genotype B and genotype C patients. The response rate of one year lamivudine treatment was higher than 50%. According to the data from treatment completed cases, the response rate was similar between the patients whose ALT was between 5 times and 10 times upper normal limit and those whose ALT above 10 times upper normal limit. The baseline HBV DNA titer, HBeAg index ratio, 3rd and 6th early e antigen response and 6th HBeAg rebound could not predict the treatment response. However, when all our patients complete the treatment, it is possible to improve the statistic power due to the increase of case numbers.
Subjects
B型肝炎病毒e抗原效價
干安能治療反應
HBeAg index value
Lamivudine treatment response
SDGs
Type
text
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