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1.
J Thorac Dis ; 10(3): 1941-1950, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29707350

RESUMO

Background: Standard management has been recommended for obstructive sleep apnea (OSA) by several guidelines, but patient choice in the practical setting is unclear. Methods: A survey nested in two prospective cohort studies of OSA (enrollment: 2001-2010) in China. The last interview was conducted between July 2014 and May 2015, using a comprehensive 10-point questionnaire administered in a face-to-face or telephone interview, and assessed (I) whether the participant had received any OSA treatment; (II) why he or she had decided for or against treatment; (III) what treatment was received; (IV) whether the participant used continuous positive airway pressure (CPAP) or OA daily; and (V) the perceived efficacy of therapy. Results: A total of 4,097 subjects with a mean age of 45 years [37-55] responded to this survey, with a response rate of 79.4% (4,097/5,160); 2,779 subjects (67.8%) did not receive any treatment: 1,485 (53.4%) believed that their condition was not serious, despite severe OSA in 53.7% of the patients. A multivariate regression showed that the decision to receive treatment was associated with: age between 45-59 years [odds ratio (OR) 0.805, 95% CI: 0.691-0.936; P<0.001], female gender (OR 0.492, 95% CI: 0.383-0.631; P<0.001), severe OSA (OR 1.92, 95% CI: 1.01-3.64; P<0.001), hypertension (OR 1.414, 95% CI: 1.209-1.654; P<0.001) and diabetes (OR 1.760, 95% CI: 1.043-2.972; P=0.034). In subjects receiving treatment (n=1,318), 50.9% reported negative perceptions about the treatments. Conclusions: Nearly two thirds of Chinese patients choose not to receive treatment after OSA diagnosis, and nearly half are negative about their treatments for OSA. This requires clinical attention, and warrants further study in different geographic settings.

2.
Proteomics Clin Appl ; 12(3): e1700090, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29350888

RESUMO

PURPOSE: The aim of this study was to screen for novel host proteins that play a role in HBx augmenting Hepatitis B virus (HBV) replication. EXPERIMENTAL DESIGN: Three HepG2 cell lines stably harboring different functional domains of HBx (HBx, HBx-Cm6, and HBx-Cm16) were cultured. ITRAQ technology integrated with LC-MS/MS analysis was applied to identify the proteome differences among these three cell lines. RESULTS: In brief, a total of 70 different proteins were identified among HepG2-HBx, HepG2-HBx-Cm6, and HepG2-HBx-Cm16 by double repetition. Several differentially expressed proteins, including p90 ribosomal S6 kinase 2 (RSK2), were further validated. RSK2 was expressed at higher levels in HepG2-HBx and HepG2-HBx-Cm6 compared with HepG2-HBx-Cm16. Furthermore, levels of HBV replication intermediates were decreased after silencing RSK2 in HepG2.2.15. An HBx-minus HBV mutant genome led to decreased levels of HBV replication intermediates and these decreases were restored to levels similar to wild-type HBV by transient ectopic expression of HBx. After silencing RSK2 expression, the levels of HBV replication intermediates synthesized from the HBx-minus HBV mutant genome were not restored to levels that were observed with wild-type HBV by transient HBx expression. CONCLUSION AND CLINICAL RELEVANCE: Based on iTRAQ quantitative comparative proteomics, RSK2 was identified as a novel host protein that plays a role in HBx augmenting HBV replication.


Assuntos
Vírus da Hepatite B/fisiologia , Proteômica , Proteínas Quinases S6 Ribossômicas 90-kDa/metabolismo , Replicação Viral , Células Hep G2 , Vírus da Hepatite B/metabolismo , Humanos , Domínios Proteicos , Proteínas Quinases S6 Ribossômicas 90-kDa/química
3.
Clin Res Hepatol Gastroenterol ; 42(1): 64-71, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28688902

RESUMO

AIM: The diagnostic performance of Fibroscan might be improved when combined with other serum fibrosis related markers. Previous study has demonstrated that S100A4 expression is associated with liver fibrosis in humans with hepatitis. This study aimed to clarify diagnostic accuracy of serum S100A4 levels for significant liver fibrosis in patients with chronic hepatitis B (CHB), and develop a combined algorithm of liver stiffness measurement (LSM) and S100A4 to predict significant liver fibrosis in CHB. METHODS: One hundred and seventy-five CHB patients who had performed liver biopsy were consecutively included. We evaluated serum S100A4 levels, LSM values and other clinically-approved fibrosis scores. RESULTS: Serum S100A4 level was higher in CHB patients with significant fibrosis, compared to those without [199.58 (33.31-1971.96) vs. 107.15 (2.10-1038.94), P<0.001]. Using receiver-operating characteristic (ROC) analyses, the area under the curves (AUC), sensitivity, specificity and accuracy of S100A4 were found to be 0.749, 62.7%, 75.9% and 0.70 for significant fibrosis (≥Stage 2), respectively. Although not superior to LSM, these results were better than the fibrosis index based on the 4 factor (FIB-4) and the aspartate aminotransferase-to-platelet ratio index (APRI) for significant fibrosis detection. An algorithm consisting of S100A4 and LSM was derived. The AUC, sensitivity, specificity and accuracy of model based on serum S100A4 level and LSM were 0.866, 86.6%, 77.8% and 0.79 for significant fibrosis detection, superior to those based on LSM alone (0.834, 76.1%, 80.7% and 0.76, P=0.041). CONCLUSION: Serum S100A4 level was identified as a fibrosis marker of liver fibrosis in patients with CHB. Combining serum S100A4 with LSM improved the accuracy of transient elastography for hepatitis B significant fibrosis detection.


Assuntos
Técnicas de Imagem por Elasticidade , Cirrose Hepática/sangue , Cirrose Hepática/diagnóstico por imagem , Proteína A4 de Ligação a Cálcio da Família S100/sangue , Adulto , Algoritmos , Técnicas de Imagem por Elasticidade/métodos , Feminino , Hepatite B Crônica/complicações , Humanos , Cirrose Hepática/etiologia , Masculino , Reprodutibilidade dos Testes
4.
Sci Rep ; 7: 45576, 2017 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-28358016

RESUMO

Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a life-threatening condition, and the lipid metabolism disorder is common in the development of this disease. This prospective observational study aimed to define the characteristics of plasma apolipoprotein A-V (apoA-V) in long-term outcome prediction of HBV-ACLF, and a total of 330 HBV-ACLF patients were included and followed for more than 12 months. In this cohort, the 4-week, 12-week, 24-week and 48-week cumulative mortality of HBV-ACLF was 18.2%(60/330), 50.9%(168/330), 59.7%(197/330) and 63.3%(209/330), respectively. As compared to survivors, the non-survivors had significantly lower concentrations of plasma apoA-V on admission. Plasma apoA-V concentrations were positively correlated with prothrombin time activity (PTA), and negatively correlated with interleukin-10, tumor necrosis factor-α, and iMELD scores. Though plasma apoA-V, PTA, total bilirubin(TBil) and blood urea nitrogen(BUN) were all independent factors to predict one-year outcomes of HBV-ACLF, plasma apoA-V had the highest prediction accuracy. And its optimal cutoff value for one-year survival prediction was 480.00 ng/mL, which had a positive predictive value of 84.68% and a negative predictive value of 92.23%. In summary, plasma apoA-V decreases significantly in non-survivors of HBV-ACLF, and it may be regarded as a new predictive marker for the prognosis of patients with HBV-ACLF.


Assuntos
Insuficiência Hepática Crônica Agudizada/complicações , Apolipoproteína A-V/sangue , Hepatite B Crônica/sangue , Hepatite B Crônica/diagnóstico , Adulto , Biomarcadores/sangue , Feminino , Hepatite B Crônica/complicações , Hepatite B Crônica/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Sensibilidade e Especificidade
5.
Sci Rep ; 7(1): 173, 2017 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-28282964

RESUMO

Recently, hepatitis B core-related antigen (HBcrAg) has been suggested as an additional marker of hepatitis B virus (HBV) infection. This study aimed to investigate whether serum quantitative HBcrAg (qHBcrAg) was a satisfactory surrogate marker of intrahepatic covalently closed circular DNA (cccDNA). A total of 139 patients with liver biopsy were enrolled, consisting of 59 patients in immune tolerance (IT) phase, 52 patients in immune clearance (IC) phase, 18 patients in low-replication (LR) phase, and 10 patients in reactivation phase. All patients in IC phase have received entecavir (ETV) therapy, and 32 of them undergone a second liver biopsy at 24 months. Among those patients, qHBcrAg was strongly correlated with intrahepatic cccDNA, which is superior to that of qHBsAg and HBV DNA. And similar findings were also observed in patients in IT, IC, LR and reactivation phases. Among the 32 ETV-treated patients with a second liver biopsy in IC phase, the decline of intrahepatic cccDNA was accompanied by changes in both qHBcrAg and qHBsAg. However, as compared to qHBsAg, the change of qHBcrAg was more strongly associated with intrahepatic cccDNA-decline. In summary, serum qHBcrAg should be a satisfactory surrogate of intrahepatic HBV cccDNA in CHB patients.


Assuntos
DNA Circular/genética , Antígenos do Núcleo do Vírus da Hepatite B/sangue , Vírus da Hepatite B/genética , Hepatite B Crônica/imunologia , Fígado/virologia , Adulto , Antivirais/uso terapêutico , DNA Viral/genética , Feminino , Guanina/análogos & derivados , Guanina/uso terapêutico , Vírus da Hepatite B/imunologia , Hepatite B Crônica/tratamento farmacológico , Hepatite B Crônica/genética , Hepatite B Crônica/virologia , Humanos , Fígado/química , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
6.
Clin Res Hepatol Gastroenterol ; 41(3): 296-302, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27988305

RESUMO

AIM: Assessment of liver fibrosis is important for the decision of whether to administrate antiviral treatment in chronic Hepatitis B (CHB) patients. The objective was to investigate the relationship between clinical factors and fibrosis, identify predictors of significant fibrosis in Chinese CHB patients. METHODS: Two hundred and seventy-four treatment-naïve CHB patients (208 HBeAg-positive and 66 HBeAg-negative) who performed transient elastography were consecutively included. We assessed ALT, HBsAg, HBeAg, HBV-DNA, HBV genotype and precore (PC)/basal core promoter (BCP) variants and liver stiffness measurement (LSM) values. RESULTS: One hundred and nine patients (39.78%) had significant fibrosis (F≥2, include those with liver cirrhosis). On univariate analysis, significant fibrosis was associated with older age (P<0.001), high ALT levels (P=0.003), lower HBsAg levels (P<0.001), lower HBV DNA levels (P<0.001), HBeAg negative (P<0.001), presence of BCP (P<0.001) and combined BCP/PC mutations (P=0.001). Multivariate logistic regression analysis showed that the strongest independently associated predictors of significant fibrosis (F≥2) were the presence of HBV BCP mutations (P<0.001) and older age (P<0.001), followed by presence of lower HBsAg (P<0.001), higher ALT levels (P=0.006), PC mutations (P=0.011). The diagnostic accuracy of the combination (age, ALT, HBsAg, BCP/PC variants) model with an area under the receiver-operating characteristic curve of 0.819 (cut-off value was 0.349, P<0.001, 95% CI 0.731-0.914) in predicting significant fibrosis. CONCLUSIONS: We identified four independent risk factors (age, ALT, HBsAg, HBV BCP/PC variants) in predicting significant fibrosis. HBV BCP variants was the strongest predictor of significant fibrosis. The combination of these four variables may facilitate the assessment and management of fibrosis in HBV infected patients.


Assuntos
Antígenos do Núcleo do Vírus da Hepatite B/genética , Antígenos E da Hepatite B/genética , Hepatite B Crônica/diagnóstico , Hepatite B Crônica/genética , Cirrose Hepática/diagnóstico , Cirrose Hepática/genética , Mutação , Regiões Promotoras Genéticas , Adulto , Biomarcadores/sangue , DNA/sangue , DNA Viral/análise , Técnicas de Imagem por Elasticidade , Feminino , Genótipo , Antígenos E da Hepatite B/sangue , Vírus da Hepatite B/genética , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Carga Viral
7.
Int J Infect Dis ; 52: 77-82, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27686728

RESUMO

BACKGROUND: The aim of this study was to determine the role of baseline hepatitis B virus (HBV) forming covalently closed circular DNA (HBV cccDNA) in liver inflammation in patients infected with HBV with serum alanine aminotransferase (ALT) levels under two times the upper limit of normal (2×ULN). METHODS: After liver biopsy and serum virological and biochemical marker screening, patients diagnosed with chronic HBV infection with serum ALT levels under 2×ULN and histological liver inflammation of less than grade G2 were prospectively recruited into this study. Recruitment took place between March 2009 and November 2010 at the Center of Infectious Disease, Sichuan University. Patient virological and biochemical markers, as well as markers of liver inflammation, were monitored. RESULTS: A total of 102 patients were recruited and 68 met the inclusion criteria; the median follow-up was 4.1 years (range 3.9-5.2 years). During follow-up, 41 patients (60.3%) exhibited signs of inflammation. Baseline HBV cccDNA >1 copy/cell (odds ratio 9.43, p=0.049) and liver inflammation grade ≥G1 (odds ratio 5.77, p=0.046) were both independent predictors of liver inflammation. CONCLUSIONS: A higher baseline intrahepatic HBV cccDNA level may increase the risk of liver inflammation. Further investigations will be required to validate HBV cccDNA as an intrahepatic virological marker of patients who require extended outpatient management.


Assuntos
DNA Viral/sangue , Vírus da Hepatite B/genética , Hepatite B Crônica/virologia , Adolescente , Adulto , Alanina Transaminase , Biomarcadores/sangue , Biópsia , DNA Circular , Feminino , Hepatite B Crônica/patologia , Humanos , Inflamação , Fígado/patologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
8.
BMJ Open ; 6(10): e012016, 2016 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-27733412

RESUMO

OBJECTIVES: Little is known about hepatitis B virus (HBV) infection in patients with hepatitis C virus (HCV) infection in China. This study aimed to evaluate the prevalence, clinical characteristics, viral interactions and host genotypes of HBV/HCV dual infection compared with HCV monoinfection. STUDY DESIGN: A cross-sectional study. SETTING: China. PARTICIPANTS AND METHODS: 997 patients with HCV from 28 university-affiliated hospitals in China were enrolled in this research. Patients were divided into two subgroups. RESULTS: The prevalence of HBV infection in patients with HCV was 4.11% (41/997). The age-specific prevalence of HBsAg was 0.70%, 3.97% and 5.85% in groups aged 18-30, 30-50 and >50 years old (p=0.057), respectively. Patients with HBV/HCV dual infection and patients with HCV monoinfection had similar HCV viral loads (5.80±0.89 vs 5.83±1.00 log10 IU/mL, p=0.904). The dominant HCV genotype was 1b in both groups (53.65% vs 56.90%, p=0.493). The protective C allele in IL-28B (rs12979860) was also the dominant allele type in both patient groups (85.36% vs 83.99%, p=0.814). Patients with HBV/HCV dual infection had a higher ratio of liver cirrhosis and hepatic decompensation than patients with HCV monoinfection (39.02% vs 17.69%, p=0.001; 31.70% vs 12.13%, p=0.001). CONCLUSIONS: The HBV burden was moderate in HCV-infected patients in China. Liver cirrhosis was more common in patients with HBV/HCV dual infection, suggesting the need for closer monitoring of dual-infected individuals. TRIAL REGISTRATION NUMBER: NCT01293279; Post-results.


Assuntos
Coinfecção/epidemiologia , Hepacivirus/patogenicidade , Vírus da Hepatite B/patogenicidade , Hepatite B , Hepatite C , Adolescente , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , China/epidemiologia , Coinfecção/genética , Coinfecção/virologia , Estudos Transversais , Feminino , Genótipo , Hepacivirus/genética , Hepatite B/epidemiologia , Hepatite B/genética , Hepatite B/patologia , Hepatite B/virologia , Vírus da Hepatite B/genética , Hepatite C/epidemiologia , Hepatite C/genética , Hepatite C/patologia , Hepatite C/virologia , Humanos , Interferons , Interleucinas/metabolismo , Cirrose Hepática/epidemiologia , Cirrose Hepática/genética , Cirrose Hepática/patologia , Cirrose Hepática/virologia , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
9.
Viral Immunol ; 29(6): 332-42, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27104358

RESUMO

Changes of Treg/Th17 cells ratio and their associated cytokines have some correlations with an immune modulatory effect of Telbivudine treatment. The aim of our study was to investigate the role of the dynamic ratio of Treg/Th17 cells in the mechanism of LdT therapy and their relationships with the clinical responses. We detected the frequency and cytokines production of Treg and Th17 cells in 28 hepatitis B envelope antigen (HBeAg)-positive CHB patients at 0, 12, 24, 36, 48, and 96 weeks after initial LdT therapy. LdT could upregulate the frequency of Th17 cells and Th17 cells associated cytokines, downregulated the frequency of Treg cells and level of TGF-ß, which leads to the decrease of Treg/Th17 ratio in HBeAg-positive CHB patients. Treg/Th17 ratio at treatment week 36 could independently predict HBeAg seroconversion in the first 2 years of Telbivudine treatment. Telbivudine therapy can decrease Treg/Th17 ratio, which may predict HBeAg seroconversion during treatment.


Assuntos
Antivirais/uso terapêutico , Antígenos E da Hepatite B/sangue , Hepatite B Crônica/tratamento farmacológico , Soroconversão , Linfócitos T Reguladores/imunologia , Células Th17/imunologia , Timidina/análogos & derivados , Adolescente , Adulto , Feminino , Hepatite B Crônica/diagnóstico , Hepatite B Crônica/patologia , Humanos , Masculino , Prognóstico , Estudos Prospectivos , Telbivudina , Timidina/uso terapêutico , Resultado do Tratamento , Adulto Jovem
10.
Ther Clin Risk Manag ; 11: 229-35, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25709465

RESUMO

OBJECTIVE: To explore the predictive value of serum hepatitis B surface antigen (HBsAg) titer and transient elastography in screening for insignificant fibrosis in hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients. METHODS: We conducted a cross-sectional study of eligible patients treated from March 2012 to May 2013 at the West China Hospital of Sichuan University. Eligible patients underwent liver transient elastography and liver biopsy. We assessed the serum HBsAg level, serum hepatitis B virus (HBV) deoxyribonucleic acid (DNA) level, HBV genotypes, liver stiffness measurement (LSM) values by transient elastography, and histological fibrosis staging by METAVIR classification. RESULTS: A total of 129 consecutive patients were recruited. The LSM value (P<0.001, odds ratio 14.67, 95% CI 0.158-0.551) and log10HBsAg (P=0.045, odds ratio 4.03, 95% CI 0.136-0.976) correlated with a liver fibrosis score

11.
Clin Res Hepatol Gastroenterol ; 39(3): 366-72, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25468548

RESUMO

BACKGROUND AND AIMS: To evaluate the antiviral response of hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) patients who had baseline high viral load (HVL), defined as having hepatitis B virus (HBV) DNA>9log 10 copies/mL, after 96weeks of entecavir (ETV) treatment. METHODS: A total of 99 HBeAg-positive CHB patients (50 with HVL and 49 with non-HVL) were treated with ETV monotherapy for 96weeks. RESULTS: Virological response (VR) (HBVDNA<300copies/mL) was achieved in 42%, 62%, 68% of HVL patients and in 67.34%, 85.71%, 85.71% of non-HVL patients at weeks 48,72,96, respectively. The VR rates of the HVL group were lower than those of the non-HVL group (P=0.006, P=0.007, and P=0.037). In the HVL group, a total of 30 patients had HBV DNA<1000copies/mL at week 48 and those patients had a 93.3% chance of achieving VR at week 96, whereas the patients who had HBV DNA levels>1000copies/mL at week 48 only had a 30% chance to achieve VR at week 96. Among the 96weeks of treatment, one patient had virological breakthrough in the HVL group and this patient had HBVDNA>1000copies/mL at week48. The rates of biochemical responses (BR) and HBeAg seroconversion (SR) were similar between the HVL group and non-HVL group at weeks 48 and 96. CONCLUSION: The baseline HVL was a negative predictor of virological response in CHB patients with ETV monotherapy. For those HVL patients treated by ETV with poor VR, which defined as HBVDNA>1000copies/mL at week48, the treatment strategies need to be adjusted.


Assuntos
Antivirais/administração & dosagem , Guanina/análogos & derivados , Hepatite B Crônica/tratamento farmacológico , Hepatite B Crônica/virologia , Carga Viral/efeitos dos fármacos , Adulto , Antivirais/farmacologia , Feminino , Guanina/administração & dosagem , Guanina/farmacologia , Antígenos E da Hepatite B/sangue , Hepatite B Crônica/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Nucleosídeos , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
12.
Hepatol Res ; 43(2): 185-91, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22978384

RESUMO

AIM: The accuracy of liver stiffness measurement (LSM) in the diagnosis of liver fibrosis is affected by elevated serum alanine aminotransferase (ALT) levels. The aim of this study was to assess the impact of mild to moderate elevations of ALT on LSM in patients with chronic hepatitis B (CHB) during antiviral therapy. METHODS: A total of 58 CHB patients with their ALT levels falling into the range of ×2 to ×10 the upper limit of normal (ULN) were recruited. ALT and LSM values were periodically assessed at baseline and 12, 24 and 48 weeks. RESULTS: The median ALT levels were 153.5 (76-544), 50.5 (11-475), 36.5 (9-265) and 30 (12-239) IU/L at baseline and 12, 24 and 48 weeks, respectively. The corresponding median value of LSM was 8.8 (3.2-47.3), 6.15 (3.2-31.2), 5.9 (3.1-29.1) and 5.5 (2.8-21.5) kpa. However, after the ALT levels were normalized by the treatment, the values of LSM did not vary significantly (6.1 [3.0-17.7] vs 5.25 [2.8-21.5] kpa, P = 0.381). Pretreatment fibrosis stages of liver biopsies corresponded with LSM after ALT normalization rather than baseline LSM (F0-1, 12/27 vs 23/25, P < 0.001). CONCLUSION: The LSM values decreased in parallel with the decline in ALT levels in CHB patients with mild to moderate elevation of ALT. LSM became more accurate when applied to document the liver fibrosis or cirrhosis in CHB patients after the elevated ALT level has been treated to normal level.

13.
Antivir Ther ; 17(6): 973-9, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22728692

RESUMO

BACKGROUND: There is no standard management of chronic hepatitis B (CHB) patients with suboptimal response to nucleoside/nucleotide analogues (NAs). This study aimed to evaluate two different NA combination therapies in patients with suboptimal response to adefovir (ADV). METHODS: In this study, 72 CHB patients with suboptimal response to ADV were assessed, with 37 patients receiving lamivudine plus ADV (group A) and 35 patients receiving telbivudine plus ADV (group B). RESULTS: Baseline characteristics between two groups were similar. At month 12, rates of biochemical response (BR) and virological response (VR) were similar between groups A and B (17/19 versus 18/20 for BR, [P=0.269] and 30/37 versus 31/35 for VR [P=0.377]), and cumulative rates of serological response were greater in group B than in group A (10/26 versus 2/28 in hepatitis B e antigen [HBeAg] loss [P=0.006] and 7/26 versus 1/28 in HBeAg/hepatitis B e antibody seroconversion [P=0.022]). After 12-month treatment, 8.1% (3/37) of patients in group A and 5.7% (2/35) of patients in group B had VR; among patients in group A, two had rtM204V/I and rtL180M and one had rtN236T, whereas the two patients in group B had rtM204I+rtL180M. CONCLUSIONS: Both combination therapies led to a significant decrease in HBV DNA. HBeAg serological outcomes were higher with telbivudine plus ADV combination therapy.


Assuntos
Adenina/análogos & derivados , Vírus da Hepatite B/patogenicidade , Hepatite B Crônica/tratamento farmacológico , Lamivudina/uso terapêutico , Nucleosídeos/uso terapêutico , Organofosfonatos/uso terapêutico , Pirimidinonas/uso terapêutico , Adenina/uso terapêutico , Adulto , Biomarcadores/sangue , DNA Viral/sangue , Quimioterapia Combinada/métodos , Feminino , Genótipo , Antígenos E da Hepatite B/sangue , Vírus da Hepatite B/genética , Hepatite B Crônica/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Estudos Prospectivos , Telbivudina , Timidina/análogos & derivados , Resultado do Tratamento , Adulto Jovem
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