血清cccDNA在阿德福韦酯治疗慢性乙型肝炎中的临床意义

目的 探讨血清cccDNA在阿德福韦酯治疗慢性乙型肝炎(CHB)中的临床意义. 方法 选取81例CHB确诊患者,对所有病例的血清cccDNA进行检测,根据检测结果分为cccDNA阳性组和cccDNA阴性组,所有患者给予阿德福韦酯治疗口服(10mg/d),每24周随访一次,连续随访4次,治疗前及随访时检测HBV DNA、HBeAg及ALT等指标. 结果 cccDNA阳性与阴性两组患者的年龄及性别比较,差异无统计学意义(P＞0.05).两组在接受阿德福韦酯治疗的过程中,HBV DNA的中位数随着治疗时间的延长而下降,阴性组下降较阳性组明显.HBeAg变化,24周时两组与各自基线及两组之间比较差异无统计学意义(P＞0.05),于48、72及96周,两组HBeAg与各自基线及两组之间比较差异有统计学意义(P＜0.05);ALT变化,两组间在基线、24和48周时比较差异无统计学意义(P＞0.05),72及96周比较差异有统计学意义(P＜0.05). 结论 随着阿德福韦酯治疗时间的延长,cccDNA阴性组的HBV DNA载量、HBeAg滴度及ALT下降较阳性组快,即阴性组应答高于阳性组,因而说明血清cccDNA能够预测阿德福韦酯的远期疗效.

Clinical value of serum cccDNA in the treatment of chronic hepatitis B by adefovir dipivoxil

Objective To investigate the clinical value of serum cccDNA in treatment of chronic hepatitis B (CHB)by adefovir dipivoxil(ADV). Methods 81 patients with CHB were selected and detected for serum cccDNA. All the patients received ADV treatment( 10 mg/d)and were followed-up once every 24 weeks, for four times. They were divided into two groups(positive and negative groups)by detecting serum cccDNA. HBV DNA, HBeAg, and ALT were detected before and after ADV treatment at week 24, 48, 72 and 96. Results There were no significant differences in age and sexual distiction between two groups of cccDNA positive and negative ( P ＞ 0. 05). The median of HBV DNA decreased gradually with the time of treatment, especially in cccDNA negative group. There was significant difference in the decrease of HBeAg at week 48,72,96( P ＜ 0.05), except the time of baseline and week 24( P ＞ 0.05). There was no significant difference in the decrease of ALT at baseline and week 24,48( P ＞ 0.05), except week 72,96( P ＜ 0.05).Conclusions Withprolonging treatment,HBV DNA, HBeAg and ALT decrease faster in cccDNA negative group than in positive group, so serum cccDNA can be seen as a predictive mark when chronic hepatitis B treated by ADV.