拉米夫定和阿德福韦及恩替卡韦治疗乙肝的现状和进展

拉米夫定、阿德福韦、恩替卡韦均可明显抑制HBVDNA的复制,降低血清中HBVDNA水平,促进血清转氨酶正常化,增加HBeAg血清转换率和HBeAg清除率,促进肝脏组织学改善,并有不良事件少,可为机体良好耐受的特点,为治疗乙肝的主流药物。本文就3种核苷类药物治疗成人、少儿及妊娠慢性乙型肝炎,乙肝相关肝硬化,防治乙肝相关肝移植肝炎复发,耐药变异,药物常见的不良反应等几个方面的现状和进展进行比较和综述,以促进临床科学、合理用药。

Status and Advance in Treatment of HBV Infection with Lamivudine,Adefovir and Entecavir

Lamivudine,Adefovir and Entecavir can significantly inhibit the replication of HBV-DNA,reduce the HBV-DNA level in blood serum,normalize serum alanine aminotransferase (ALT),elevate the rates of hepatitis e antigen (HBeAg) seroconversion and HBeAg elimination,promote the improvement of the liver in histology,and with less side-effect and better tolerability.They play a pivotal role in treatment of hepatitis B.This review gives a comparison and overview of recent findings and developments of these three types of nucleoside analogs in (1) treatment of adults,children and pregnant women with chronic hepatitis B,(2) treatment of hepatitis B-related cirrhosis,(3) prophylaxis and treatment of recurrent hepatitis B after liver transplantation,(4) resistance-associated mutation,and (5) common side-effects,with a purpose to promote a scientific and reasonable medication clinically.