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만성B형 간염 항바이러스제와 진단표지 사이의 관계

The Relationship between Antiviral Drugs for Chronic Hepatitis B and Diagnostic Markers

정다운|현성희|김인식
대한임상검사과학회 (Korean Society for Clinical Laboratory Science)|2011.06|대한임상검사과학회지 (Korean Journal of Clinical Laboratory Science)|제43권 제2호|pp. 57-67

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Abstract

In this study, we investigated the correlation between the administration of various antiviral agents and the alternation of specific biomarkers induced by the hepatitis B virus (HBV). Eligible subjects diagnosed with chronic hepatitis B were prescribed with antiviral drugs at the Gastroenterology Internal Medicine Department of E University Hospital in Daejeon between May 2004 and September 2009. Lamivudine was prescribed to 66 out of 100 patients. Of the 12 patients, 6 (50.0%) showed a change from being HBe-antigen-positive to being HBe-antigen-negative. Of the 39 patients, 23 (59.0%) showed higher than 40 IU/L alanine aminotransferase (ALT). Of the 65 patients, 41 (63.1%) showed HBV DNA decrease of 1 log, and were prescribed with Lamivudine. Adefovir was prescribed to 3 out of 100 patients. Of the 12 patients, 1 (8.3%) showed a change from being HBe-antigen-positive to being HBe-antigen-negative, and was prescribed with Adefovir. Entecavir was prescribed to 19 (19.0%) out of 100 patients. Of the 12 patients, 3 (25.0%) showed a change from being HBe-antigen-positive to being HBe-antigen-negative. Of the 12 patients, 3 (125.8%) showed higher than 40 IU/L ALT. Of the 65 patients, 14 (21.5%) showed HBV DNA decrease of 1 log, and were prescribed with Entecavir. Clavudine was prescribed to 7 out of 100 patients. Of the 12 patients, 1 (8.3%) showed a change from positive HBe antigen to negative HBe antigen. Of the 39 patients, 5 (12.8%) showed higher than 40 IU/L ALT. Of the 65 patients, 6 (9.2%) showed HBV decrease of 1 log, and were prescribed with Clavudine. These results do not show a statistically significant correlation between drugs and biomarkers. Data on combination therapy using Lamivudine and Adefovir show no statistically significant difference between drugs and biomarkers. Medications for periodic inspection was not correlated to HBe-antigen-negative conversion, ALT, and HBV DNA. HBV DNA was significantly reduced in patients with high levels of AST(aspartic acid aminotransferase) and ALT before treatment. In addition, the decrease of HBV DNA after 12 months of treatment was less frequently observed in patients treated with Lamivudine compared with other drugs. This result is associated with Lamivudine resistance. Although the association of drugs with diagnostic markers and the correct choice of treatment is difficult to determine, these results may be useful for further research on diagnosis and treatment of the hepatitis B virus.

참고문헌 (28)

  1. ACT-HBV Asia-Pacific Steering Committee Members, "Chronic hepatitis B: treatment alert", Liver Int, 26(Suppl2), pp.47~58 (2006)
  2. Allen MI, "Identification and characterization of mutations in hepatitis B virus resistant to lamivudine", Hepatology, 27, pp.1670~1677 (1998)
  3. Beasley RP, "Hepatocellular carcinoma and hepatitis B virus: a prospective study of 22707men in Taiwan", Lancet, 2, pp.1129~1133 (1981)
  4. Chang TT, "A comparison of entecavir and lamivudine for HBeAg positive chronic hepatitis B", N Engl J Med, 354, pp.1001~1010 (2006)
  5. Chin R, "In vitro susceptibilities of wild-type or drug resistant hepatitis B virus to (-)-beta-D-2,6-diamino purine dioxolane and 2’fluoro - 5 - methyl - beta - L - arabinofuranosyluracil", Antimicrob Agents Chemother, 45, pp.2495~2501 (2007)
  6. Chon Cy, "Long-term Efficacy and Durability of Lamivudine Therapy in Patients with Chronic Hepatitis B", Koream J Hepatol, 7, pp.423~431 (2001)
  7. Dienstag JL, "Histological outcome during long-term lamivudine therapy", Gastroenterology, 124, pp.105~117 (2003)
  8. Hadziyannis SJ, "Long-term therapy with adefovir dipivoxil for HBe Ag-negative chronic hepatitis B", N Engl J Med, 352, pp.2673~2681 (2005)
  9. Hadziyannis SJ, "Long-term therapy with adefovir dipivoxil for HBe Ag-negative chronic hepatitis B for up to 5 years", Gastroenterology, 131, pp.1743~1751 (2006)
  10. Keeffe EB, "A treatment algorithm for the management of chronic hepatitis B virus infection in the United States: an update", Clin Gastroenterol Hepatol, 4, pp.936~962 (2006)
  11. Lai CL, "Entecavir versus lamivudine for patients with HBe Ag negative chronic hepatitis B", N Engl J Med, 354, pp.1011~1020 (2006)
  12. Lampertico P, "Adefovir and lamivudine combination therapy is superior to adefovir monotherapy for lamivudine-resistant patients with HBe Ag negative chronic hepatitis B", J Hepatol, 46(Suppl 1), pp.191~ (2007)
  13. Liaw YF, "Lamivudine for patients with chronic hepatitis B and advanced liver disease", N Engl J Med, 351, pp.1521~1531 (2004)
  14. Lin SM, "Interferon therapy in HBe Ag positive chronic hepatitis reduces cirrhosis and hepatocellular carcinoma", J Hepatol, 46, pp.45~52 (2007)
  15. Lok AS, "Long-term safety of lamivudine treatment in patients with chronic hepatitis B", Gastroenterology, 125, pp.1714~1722 (2003)
  16. Lok AS, "Chronic hepatitis B", Hepatology, 45, pp.507~539 (2007)
  17. Perrillo RP, "Treatment of chronic hepatitis B with interferon:experience in western countries", Semin Liver Dis, 9, pp.240~248 (1989)
  18. Rapti I, "Adding - on versus switching - to adefovir therapy in lamivudine - resistant HBe Ag negative chronic hepatitis B", Hepatology, 45, pp.307~313 (2007)
  19. Seifer M, "In vitro inhibition of hepadnavirus polymerases by the triphosphates of BMS-200475 and lobucavir", Antimicrob Agents Chemother, 42, pp.3200~3208 (1998)
  20. Wong DK, "Quantitation of covalently closed circular hepatitis B virus DNA in chronic hepatitis B patients", Hepatology, 40, pp.727~737 (2004)
  21. Yuen MF, "Factors associated with hepatitis B virus DNA breakthrough in patients receiving prolonged lamivudine therapy", Hepatology, 34, pp.785~791 (2001)
  22. 강성호, "만성 B형 간염과 간경변 환자에서 Lamivudine 저항성 B형 간염 바이러스의 출현양상 및 YMDD motif 돌연변이 검출", 대한간학회지, 7(1), pp.15~33 (2001)
  23. 박능화, "B형 간염 바이러스에 의한 만성 간질환에서 라미부딘의 치료효과", 대한간학회지, 7(1), pp.77~89 (2001)
  24. 서동진, "만성 B형 간염 환자에서 lamivudine 12주 치료의 효과와 안전성", 대한간학회지, 5(2), pp.89~96 (1999)
  25. 서현주, "라미부딘과 아데포비어에 순차 내성을 보인 만성 B형 간염 환자에서 라미부딘", 아데포비어 병합요법의 항바이러스 효과, 2009, pp.53(5), 305~310[DOI]
  26. 신정우, "만성 B형 간염 치료", 대한내과학회지, 77(3), pp.265~274 (2009), 대한내과학회
  27. 이관식, "Guideline Committee of the Korean Association for the Study of the Liver. Management of chronic hepatitis B", 대한간학회지, 13(4), pp.447~488 (2007)
  28. 이헌주, "난치성 만성 B형 간염 바이러스 간질환 환자에 대한 lamivudine 투여효과", 대한간학회지, 6(1), pp.73~81 (2000)

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