Abstract:Objective To evaluate the efficacy and changes in renal function of telbivudine for patients with HBeAg positive chronic hepatitis B(CHB).Methods 30 patients were randomized into telbivudine(LDT) monotherapy group(10 patients),telbivudine plus adefovir(LDT+ADV) combination therapy group (10 patients), and lamivudine plus adefovir(LAM+ADV) combination therapy group(10 patients) for 96 weeks.Serum ALT normalization rate ,rate of undetectable HBV-DNA, HBeAg/anti-HBe seroconversion rate,glomerular filtration rate(GFR) were detected at 12,24,48,72,96weeks ,respectively.Results The virological response rates in the three groups were 100% at weeks 48.LDT monotherapy group first exhibited biochemical response.After 48 weeks ,biochemical response in the three group reached 100%.Serological response in LDT monotherapy group(50%) was significantly higher than in telbivudine plus adefovir combination therapy group(40%) and lamivudine plus adefovir combination therapy group (0%)at 72 weeks.After 96 weeks,GFR in Telbivudine monotherapy group (112.26±2.86)ml/(min·1.73 m2) was significantly higher than baseline;GFR in telbivudine plus adefovir combination therapy group(100.65±2.61)ml/(min·1.73 m2) gradually increased from baseline;and unchanged in lamivudine plus adefovir combination therapy group (92.03±2.08)ml/(min·1.73 m2).Conclusions Telbivudine can a potently and rapidly inhibit HBV DNA replication,and is efficient in e antigen seroconversion rate. Telbivudine monotherapy or combined with adefovir can significantly improve the patients’ glomerular filtration rate, and thus improve renal function.
张金龙,莫国生,刘芙蓉,揭中华,黄志刚. e抗原阳性慢性乙型肝炎替比夫定初治的抗病毒疗效[J]. 武警医学, 2015, 26(12): 1206-1209.
ZHANG Jinglong, MO Guosheng, LIU Furong, JIE Zhonghua, and HUANG Zhigang. Efficacy and Follow-up of changes in renal function of telbivudine in treatment for patients with HBeAg positive chronic hepatitis B. Med. J. Chin. Peop. Armed Poli. Forc., 2015, 26(12): 1206-1209.
Lavae Mokhtari M, Mohammad Khani S, Schmidt R E,et al.Acute renal failure and hypercalcemia in an AIDS patient on tenofovir and low dose vitamin D therapy with immune reconstitution inflammatory syndrome [J]. Med Klin (Munich),2009, 104 (10) : 810-813.
[3]
Lavae Mokhtari M, Mohammad Khani S, Schmidt R E,et al.Acute renal failure and hypercalcemia in an AIDS patient on tenofovir and low dose vitamin D therapy with immune reconstitution inflammatory syndrome [J]. Med Klin (Munich),2009, 104 (10) : 810-813.
[4]
Kim Y J,Cho H C,Sinn D H,et al.Frequency and risk factors of renal impairment during long-term adefovir dipivoxil treatment in chronic hepatitia B patients[J].J Gastroenterol Hepatol,2011,7(20):1440-1746.
[4]
Kim Y J,Cho H C,Sinn D H,et al.Frequency and risk factors of renal impairment during long-term adefovir dipivoxil treatment in chronic hepatitia B patients[J].J Gastroenterol Hepatol,2011,7(20):1440-1746.
[5]
Li L,Dong G F,Zhang X,et al.Adefovir dipivoxil induced Fanconi syndrome and hypophosphatemic osteomalacia associated with muscular weakness in a patient with chronic hepatitis B [J].Nan Fang Yi Xue Bao,2011,31(11):1956.
[6]
Fabbriciani G, De Socio G V,Massarotti M,et al.Adefovir induced hypophosphatemic osteomalacia [J].Scand J Infct Dis,2011,43(11-12):990-992.
[5]
Li L,Dong G F,Zhang X,et al.Adefovir dipivoxil induced Fanconi syndrome and hypophosphatemic osteomalacia associated with muscular weakness in a patient with chronic hepatitis B [J].Nan Fang Yi Xue Bao,2011,31(11):1956.
[6]
Fabbriciani G, De Socio G V,Massarotti M,et al.Adefovir induced hypophosphatemic osteomalacia [J].Scand J Infct Dis,2011,43(11-12):990-992.
[7]
Izzedine H, Kheder E R, Housset P, et al.Adefovir dipivoxil-induced acute tubular necrosis and Fanconi syndrome in a renal transp lant patient[J]. AIDS, 2009,23(4):544-545.
[8]
Gane E J,Deray G,,Liaw Y F,et al.Telbivudine improves renal function in patients with chronic hepatitis B[J]. Gastroenterology,2014,146(1):138-146.
[7]
Izzedine H, Kheder E R, Housset P, et al.Adefovir dipivoxil-induced acute tubular necrosis and Fanconi syndrome in a renal transp lant patient[J]. AIDS, 2009,23(4):544-545.