阿德福韦治疗肝移植术后乙肝病毒再感染的研究

目的 探讨和评价阿德福韦对因拉米呋啶耐药而出现HBV再感染的肝移植病例的抗病毒疗效。方法 9例存在拉米呋啶耐药株的肝移植术后HBV再感染者，治疗组（8例）予以改服阿德福韦酯，对照组（1例）加服泛昔洛韦治疗，并对两组病例的HBV DNA复制、乙肝血清学标志物、肝功、肾功等指标进行定期随访。结果 治疗组6例（75％）于服药后2～3个月均实现HBV DNA的阴转，1例（12．5％）维持低水平状态（10^3 copies／ml），且各有1例分别实现了HBsAg的阴转和HBeAg／HBeAb的血清学转换，肝功能均明显改善。对照组治疗前后各项指标无明显变化。结论 对拉米呋啶耐药而导致的HBV再感染的肝移植病人，新一代核苷类药物阿德福韦，能够有效的抑制HBV变异株的复制，改善肝功能。

Therapeutic effects of adefovir on HBV reinfection after liver transplantation

Objective To investigate the therapeutic effects of adefovir on HBV reinfection after liver transplantation. Methods Nine patients with lamivudine-resistant HBV reinfection after liver transplantation were enrolled in this study. For the 9 patients, 8 were treated with adefovir alone and 1 with lamivudine in combination with fameielovir. The serum HBVM, HBVDNA and liver function were regularly determined. Results In the group of giving adefovir alone, 6 patients were HBV DNA- negative 2 or 3 months after the treatment and 1 showed low copy level. HBsAg negativity and HBeAg/HBeAb seroeonversion were found in 2 patients, respectively. Clinical liver improvement in liver function was also observed. There was no significant change in virus and liver function before and after the treatment in the control group. Conclusions Adefovir is highly effective for reducing HBV replication in patients with lamivudine-resistant HBV reinfection after liver transplantation.