Long-Term Adefovir Therapy Useful for Chronic Hepatitis B

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长期阿德福韦治疗对慢性乙型肝炎者有益
NEW YORK (Reuters Health) Jan 30 - Treatment with adefovir dipivoxil for up to 5 years is well tolerated and provides a variety of benefits for patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B, new research shows.
纽约（路透通讯社 健康）1月30日报道
-----新的研究显示，使用阿德福韦二匹伏酯<抗病毒药>对乙型肝炎患者进行治疗5年，其可以良好的耐受，并且对慢性乙型肝炎e抗原阴性的患者有多种益处。
Patients with HBeAg-negative chronic hepatitis B are at increased risk for progression to cirrhosis and hepatocellular carcinoma and rarely experience spontaneous, sustained remission. Therefore, continuous antiviral therapy is typically required.
慢性乙型肝炎e抗原阴性的患者进展为肝硬化和肝细胞癌的风险增加，而且很少会自愈和减轻。因此，非常需要持续的抗病毒治疗。
Early research has shown that a 48-week course of adefovir provides clinical improvements in patients with HBeAg-negative chronic hepatitis B. Unfortunately, these benefits disappear upon drug discontinuation. The focus of the present study was to determine the safety and efficacy of adefovir treatment for up to 5 years.
早期的研究已经显示，对慢性乙型肝炎e抗原阴性的患者进行48周阿德福韦治疗后，获得了临床上的改善。可惜的是，这些好处在药物停用后消失了。目前研究的焦点是确定使用阿德福韦5年治疗的安全性和有效性。
As reported in the December issue of Gastroenterology, Dr. Stephanos J. Hadziyannis, from the Henry Dunant Hospital in Athens, Greece, and colleagues assessed the clinical outcomes of 185 patients who were randomized to receive adefovir or placebo. The duration of adefovir therapy ranged from 48 to 240 weeks.
12月份的胃肠杂志上报道，来自希腊雅典的亨利-杜纳特医院的Stephanos J. Hadziyannis医生和他的同事把185个患者随机分为接受阿德福韦治疗组和安慰剂组，并且对临床结果进行了评估。阿德福韦治疗的持续时间为48周到240周。
At 240 weeks, 67% of adefovir-treated patients had serum hepatitis B virus (HBV) DNA levels below 1000 copies/mL and 69% of patients had achieved normal alanine aminotransferase levels.
在240周时，67%接受阿德福韦治疗患者的血清HBV-DNA水平低于1000复制份数/ml，69%的患者的丙氨酸转氨酶浓度达到了正常水平。
With long-term adefovir therapy, necroinflammation and fibrosis improved in 83% and 73% of patients, respectively. The percentage of patients with improved fibrosis scores, relative to baseline, was directly related to the duration of adefovir therapy, ranging from 35% after 48 weeks to 71% after 240 weeks.
长期使用阿德福韦，83%患者的坏死性感染和73%患者的纤维化分别得到了改善。相对于基线而言，纤维化得到改善患者的百分比与阿德福韦治疗的持续时间直接相关，从使用48周后的35%到使用240周后的71%。
After 240 weeks of therapy, the cumulative rates of HBV polymerase mutations, virologic resistance, and clinical resistance were 29%, 20%, and 11%, respectively.
经过240周的治疗后，HBV聚合酶的蓄聚率、病毒的耐药率和临床耐药率分别是29%，20%和11%。
Four patients experienced mild elevations in creatinine levels, the investigators point out.

\"Treatment with adefovir dipivoxil for up to 240 weeks produces sustained suppression of HBV DNA levels, durable normalization of ALT, and continued improvement in liver histology,\" the authors conclude.
研究人员指出，4个患者的肌酐水平轻微升高。“使用阿德福韦二匹伏酯治疗240周，可以达到持续抑制HBV DNA水平，ALT的持续正常和肝脏组织学不断改善的效果”该文作者总结道。
\"With its safety, durable efficacy, and delayed resistance for up to 5 years, adefovir dipivoxil is a primary therapeutic option for the treatment of HBeAg-negative chronic hepatitis B.\"
鉴于其使用5年具有安全、持久的疗效和延迟的耐药性，阿德福韦二匹伏酯是慢性乙型肝炎e抗原阴性的患者主要的治疗选择。
Gastroenterology 2006;131:1743-1751.