恩替卡韦对不同病毒载量慢性乙型肝炎患者的长期疗效观察

目的探讨长期应用恩替卡韦（ETV）对不同HBV DNA载量的慢性乙型肝炎患者的疗效。方法77例患者参照GLOBE研究方案，对基线HBVDNA〉10^7拷贝／mL的50例与HBV DNA〈10^7拷贝／mL的27例进行ETV抗病毒疗效比较。分别于治疗前及治疗24、48、96和157周时检测ALT、HBV DNA、HBV血清学标志物等指标，并对治疗后的应答情况进行分析。结果ETV治疗157周时基线HBV DNA〉10^7拷贝／mL和〈10^7拷贝／mL者的完全病毒学应答率分别为80．0％和77．8％（X2=0．053，P〉0．05），两组HBeAg阴转率和HBeAg血清转换率分别为46．0％、42．0％和63．0％、63．O％，差异没有统计学意义X^2=2．021和3．082，P均〉0．05）。两组ALT复常率分别为90．0％和85．2％，差异无统计学意义X^2=0．394，P〉0．05）。结论长疗程恩替卡韦治疗不同基线HBVDNA水平慢性乙型肝炎的疗效基本相同。

Efficacy of long-term entecavir treatment for chronic hepatitis B patients with different hepatitis B viral loads

Objective To explore the efficacy of long-term entecavir treatment for chronic hepatitis B patients with different HBV DNA loads. Methods According to GLOBE research program, 77 patients received antiretroviral therapy by entecavir, including 50 patients with HBV DNA〉107 copies/mL and 27 patients with HBV DNA〈107 copies/mL. ALT levels, HBV DNA loads, and the serum markers of hepatitis B were detected before and 24, 48, 96 and 157 weeks after treatment and compared between two groups. The response rate was analyzed. Results After 157-week treatment with entecavir, the complete virological response rate of the patients with baseline HBV DNA〉 107copies / mL and 〈107 copies / mL were 80.0% and 77.8% （）（2=0.053, P〉0.05）, respectively; HBeAg negative rate and HBeAg serological response rate were 46.0% ,42.0% and 63.0% ,63.0%, respectively （X2=2.021 and 3.082,Ps〉0.05）; the ALT recovery rate were 90.0% and 85.2%, respectively （Xa= 0.394,P〉0.05）. Conclusions The effect of long-term entecavir on chronic hepatitis B is irrespective of baseline levels of HBV DNA.