阿德福韦酯对慢性乙型肝炎患者HBV特异性CTL的影响

目的 探讨阿德福韦酯对慢性乙型肝炎（CHB）患者HBV特异性CTL的影响.方法 对HBV DNA阳性（HBV DNA≥1×104拷贝/ml）、ALT＞2×正常值上限（ULN）、人白细胞抗原（HLA）-A2阳性的CHB患者用阿德福韦酯（正大天睛药业公司生产）10 mg,口服,每日1次,3个月.用实时荧光定量PCR检测HBV DNA,流式细胞术检测HBV特异性CTL.结果 阿德福韦酯治疗3个月后,HBV特异性CTL（0.52±0.11）%高于治疗前（0.34±0.14）%,t=6.78 P＜0.01,HBV DNA阴转（＜1×103拷贝/ml）28例（62.22%）.17例未阴转的患者,HBV DNA水平治疗后3个月[（4.18±0.4）log10拷贝/ml]低于治疗前[（6.23±0.73）log10拷贝/ml]t=9.99,P＜0.01.结论 阿德福韦酯能提高CHB患者的HBV特异性细胞免疫功能.

Influence of adefovir dipivoxil on HBV specific CTL in patients with chronic hepatitis B

Objective To explore the influence of adefovir dipivoxil on HBV specific CTL in patients with chronic hepatitis B (CHB). Methods 10 mg adefovir dipivoxil (Zhengda Tianjing Pharmaceutical Company) was used for CHB patients with positive HBV DNA (HBV DNA ≥ 1 × 104 copies/ml) ,ALT ＞ 2 × upper limit of normal value (ULN) and positive human leucocyte antigen (HLA)-A2,orally,once a day for 3 months. Real time fluorescent quantitative PCR was used to determine HBV DNA and flowcytometer was used to determine HBV specific CTL. Results After treatment with adefovir dipivoxil for 3 months, HBV specific CTL (0. 52 ± 0. 11 )% was higher than that before treatment(0. 34 ± 0. 14 )% , t =6.78 P ＜0. 01, HBV DNA of 28 cases turned to negative ( ＜ 1 × 103copies/ml) (62. 22% ). HBV DNA of 17 cases failed to turn negative 3 months after treatment,but their HBV DNA level was lower [(4. 18 ±0.4)log 10 copies/ml] than that before treatment [(6. 23 ± 0. 73 ) log 10 copies/ml], t = 9.99, P ＜ 0.01.Conclusion adefovir dipivoxil can improve HBV specific cellular immunity in patients CHB.