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Factors Predicting the Efficacy of Adefovir Dipivoxil on Treatment-Na?ve Chronic Hepatitis B Patients at 48 Weeks

机译:预测阿德福韦酯对48周初治慢性乙型肝炎患者的疗效的因素

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Background/AimsTo reveal possible factors predicting the effect of adefovir dipivoxil (ADV) treatment on chronic hepatitis B (CHB) and optimize the utilization of ADV.MethodsIn total, 168 treatment-na?ve CHB patients were enrolled, including 117 hepatitis B e antigen (HBeAg)-positive patients and 51 HBeAg-negative patients who met the inclusion criteria. All patients were treated with ADV 10 mg per day for 48 weeks. Multiple logistic regression analyses were used to investigate baseline factors, and responses at weeks 12 and 24 were analyzed as predictive values.ResultsMultiple regression analyses showed that baseline HBeAg status and HBV DNA levels significantly affected the virological response (VR) (p<0.05), baseline ALT levels were an independent predictor of serological response (SR) (p<0.05) and the body mass index (BMI) may affect the biochemical response (BR) (p<0.05). There was a statistically significant difference in the VR and SR between patients with a primary nonresponse (PNR) at week 12 and those with a VR at week 12 (p<0.01). Additionally, the VR was significantly different between patients with HBV DNA lower than 103 copies/mL at week 24 and those with greater than 103 copies/mL (p<0.01).ConclusionsPatients with negative HBeAg, lower HBV DNA levels and higher ALT values at baseline are more suitable for ADV treatment, whereas patients with lower BMIs may be more amenable to ALT normalization. Adjustments for treatment strategy should be considered if PNR at week 12 or HBV DNA ≥103 copies/mL at week 24 is observed.
机译:背景/目的为揭示预测阿德福韦酯(ADV)治疗对慢性乙型肝炎(CHB)疗效的可能因素并优化ADV的利用方法。方法总共招募了168名初次治疗的CHB患者,其中包括117例乙肝e抗原(HBeAg)阳性患者和51例符合入选标准的HBeAg阴性患者。所有患者均接受每天10 mg ADV的治疗,持续48周。进行多元logistic回归分析以调查基线因素,并以第12周和第24周的响应作为预测值。结果多元回归分析显示基线HBeAg状态和HBV DNA水平显着影响病毒学响应(VR)(p <0.05),基线ALT水平是血清反应(SR)的独立预测因子(p <0.05),而体重指数(BMI)可能会影响生化反应(BR)(p <0.05)。在第12周时有原发性无反应(PNR)的患者与在第12周时有VR的患者之间,VR和SR的差异具有统计学意义(p <0.01)。此外,在第24周时HBV DNA低于103拷贝/ mL的患者与大于103拷贝/ mL的患者之间的VR差异显着(p <0.01)。结论HBeAg阴性,HBV DNA水平较低和ALT值较高的患者基线更适合ADV治疗,而BMI较低的患者可能更适合ALT正常化。如果在第12周观察到PNR或在第24周观察到HBVDNA≥103拷贝/ mL,则应考虑调整治疗策略。

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