基线病毒载量对阿德福韦酯治疗HBeAg阴性慢性乙型肝炎疗效的影响

目的：探讨不同基线病毒载量HBeAg阴性慢性乙型肝炎（CHB）使用阿德福韦酯（ADV）抗病毒治疗的疗效。方法：将49例HBeAg阴性CHB患者根据基线HBV DNA分为低病毒载量组（A组，HBV DNA〈10。拷贝／ml）26例及高病毒载量组（B组，HBV DNA≥10^6拷贝／ml）23例，均采用ADV治疗，每12周复查HBV DNA、HBV标志物及ALT，选取治疗12、24、48周的检验数据进行比较分析。结果：治疗12、24、48周A组HBV DNA下降幅度（1g值）分别是2．8±1．1、3．1±0．7、3．3±0．6，B组下降幅度则分别是3．8±1．4、4．3±1．4、4．7±1．1，各阶段B组下降幅度更显著（P〈0．05）。A组各阶段完全病毒学应答率（〈100拷贝／ml）65．4％、76．9％、92．3％、B组分别为34．8％、39．1％、65．2％，A组均优于B组（P〈0．05）。生物化学应答率A组分别是57．7％、69．2％、92．3％，B组为60．9％、65．2％、87．0％，各阶段差异均无统计学意义（P〉0．05）。结论：基线病毒栽量较高的病例使用ADV治疗，虽然其HBV DNA下降较明显，但完全病毒学应答率较低。基线病毒载量可作为疗效预测的重要参考依据。

Curative effect of different baseline viral load in HBeAg-negative chronic hepatitis B patients treated with adefovir dipivoxil

Objective： To investigate the curative effect of different baseline viral loads in HBeAg-negative chronic hepatitis B （HBeAg- CHB） patients antiviral therapy with adefovir dipivoxil （ADV） . Methods： Forty-nine HBeAg- CHB patients were divided into two groups, 26 cases of low viral load in group A and 23 cases of high viral load in group B. The baseline viral load of patients in group A was lower than l06 copies/ml, the baseline viral load of group B was greater than or equal to 10^6copies/ ml, and all patients were treated with ADV. Then HBV DNA level, markers of hepatitis B virus and alanine aminotransferase （ALT） were evaluated every 12 weeks, and we compared and analysed 12, 24, 48 weeks＇testing data. Results： The mean reduction from baseline in HBV DNA levels （lg value） in group A at week 12, 24, 48 were 2. 8 ± 1.1, 3. 1 ±0. 7, 3.3 ±0. 6, in group B were 3.8 ± 1.4, 4. 3 ± 1.4, 4.7 ± 1.1, there was statistical significant difference in each phase of treatment （P 〈 0. 05） . The complete virological response rate （ 〈 100copies/ml） in group A were 65.4%, 76. 9% , 92. 3% , in group B were 34. 8%, 39. 1%, 65.2% recpectively. There was statistical significant difference at each time point （P 〈 0. 05 ） . In group A , biochemical response rate were 57.7%, 69. 2%, 92. 3%, and in group B were 60. 9%, 65.2%, 87. 0%. There was not statistical significant difference in each phase （ P 〉 0.05 ） . Conclusion： The mean reduction from baseline in HBV DNA levels of high baseline viral load patient who treat with ADV were obvious, but the complete virological response rate were lower. Baseline viral load is important reference basis for curative effect prediction.