阿德福韦酯治疗不同HBV基因型感染慢性乙型肝炎患者48周疗效分析

目的观察阿德福韦酯初始治疗慢性乙型肝炎患者48周疗效及其与HBV基因型的关系。方法 75例慢性乙型肝炎患者接受国产阿德福韦酯治疗48周,观察治疗期间ALT、AST、HBV DNA、HBeAg等指标变化,并检测患者HBV基因型。结果在75例中检出B基因型49例（65.3%）,C基因型22例（29.3%）,B/C基因型4例（5.3%）;治疗48周时ALT复常率和HBV DNA转阴率分别为58.7%和50.7%,HBeAg消失率为34.9%,HBeAg血清转换率为1.5%;在治疗12周时,B基因型组ALT复常率和HBV DNA阴转率分别为26.5%和38.8%,48周时为55.1%和53.1%,在治疗12周时,C基因组ALT复常率和HBV DNA阴转率为13.6%和31.8%4,8周为59.1%和36.4%（P〉0.05）。结论基线HBV DNA〉1×105copies/ml的慢性乙型肝炎患者初始采用ADV治疗,HBeAg血清学转换率较低,ADV治疗的疗效与HBV基因型无关。

The efficacy of adefovir dipivoxil on patients with chronic hepatitis B and its association with HBV genotypes

Objective To evaluate the efficacy of adefovir dipivoxil（ADV） on patients with chronic hepatitis B,and its association with HBV genotypes.Methods 75 patients with chronic hepatitis B were treated with ADV for 48 weeks,and the HBV genotypes were detected.Results In all patients,HBV genotype B,C and B/C were 49（65.4%）,22（29.3%） and 4（5.3%）,respectively;ALT normalization and HBV DNA negative rates at week 48 were 58.7% and 50.7%,HBeAg loss and HBeAg seroconversion rates were 34.9% and 1.5%,respectively;The ALT normalization and HBV DNA negative rate in genotype B group at week 12 were 26.5% and 38.8%,which came to 55.1% and 53.1% at week 48,respectively,while in genotype C group at 12 week were 13.6% and 31.8%,which came to 59.1% and 36.4% at 48 week,respectively.Conlusions The baseline HBV DNA levels affect the antiviral response to ADV,especially in patiens with HBV DNA1×105copies/ml.There was no association between the efficacy of adefovir dipivoxil and HBV genotypes.