| 3 | 慢性乙型肝炎患者对阿德福韦的病毒学应答和耐药性研究显示文摘Abstract Abstract Background: The incidence and risk factors for adefovir-resistant HBV have not been clearly defined. Aims: To characterize the virologic response to adefovir, to determine the rate of adefovir resistance and to explore factors associated with initial virologic response (IVR) and adefovir resistance. Methods: All hepatitis B patients who received adefovir for ≥ 6 months at our center were prospectively monitored for virologic response and adefovir resistance. Results: Forty three patients were included; mean treatment duration was 18 months (range 6-45). Thirty four (79% ) patients had prior lamivudine. IVR was observed in 44% patients and associated with higher pretreatment ALT (P=0.05) and the absence of HBeAg (P=0.02). Six (14% ) patients were found to have adefovir-resistant mutations. The cumulative probability of genotypic resistance to adefovir at month 24 was 22% . Patients with adefovir resistance were more likely to have been switched from lamivudine to adefovir monotherapy (P=0.01), to be older (P=0.04), and to be infected with HBV genotype D (P=0.02). Conclusions: Roughly 50% of patients failed to achieve IVR on adefovir. The cumulative probability of adefovir resistance at 2 years was 22% . Our data suggest that combination of lamivudine and adefovir may prevent emergence of adefovir resistance in patients with lamivudine-resistant HBV. | Fung S.K. Chae H.B. Fontana R.J. A.S.F. Lok 刘丽娜 | 2006 | 世界核心医学期刊文摘(胃肠病学分册)2006，2，5： | 0 |
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