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Clinical efficacy of entecavir therapy and factors associated with treatment response in naive chronic hepatitis B patients

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dc.contributor.author이, 명희-
dc.contributor.author임, 선교-
dc.contributor.author전, 수진-
dc.contributor.author강, 창준-
dc.contributor.author조, 영주-
dc.contributor.author김, 순선-
dc.contributor.author이, 다미-
dc.contributor.author정, 재연-
dc.contributor.author조, 성원-
dc.date.accessioned2014-02-06T06:17:30Z-
dc.date.available2014-02-06T06:17:30Z-
dc.date.issued2009-
dc.identifier.issn1738-222X-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/9213-
dc.description.abstract목적: 엔테카비어는 만성 B형간염의 초치료 환자에서 강력한 항바이러스 효과 및 낮은 내성률이 보고되고 있다. 본 연구에서는 단일 기관에서 경험한 엔테카비어의 혈청, 생화학, 바이러스반응을 관찰하고 엔테카비어의 치료반응과 연관된 인자를 규명하고자 하였다.



대상과 방법:12개월 이상 1일 1회 0.5 mg의 엔테카비어를 경구 투여받은 114명의 만성 B형간염 환자를 대상으로 하였다. 초기바이러스반응은 치료 3개월 후 혈청 HBV DNA가 2,000 copies/mL 미만으로 감소한 경우로 정의하였다.



결과: 엔테카비어 투여 후 혈청 ALT값의 정상화는 치료 6개월, 12개월, 24개월에 각각 76명(68.5%), 85명(74.6%), 62명(81.6%)에서, HBV DNAPCR 음전은 각각 50명(43.9%), 81명(71.1%), 65명(85.5%)에서 관찰되었다. HBeAg 혈청소실은 6개

월에 17명(36.2%), 12개월에 27명(43.5%), 24개월에 22명(56.4%), 혈청전환은 각각 8명(12.9%), 9명(14.5%), 6명(15.4%)에서 관찰되었다. HBV DNA PCR 음전을 예측할 수 인자는 단변량 분석에서 HBeAg 유무, 치료 전 혈청 AST치, 혈청 HBV DNA치, 초기바이러스반응 유무였고, 다변량 분석에서 초기바이러스반응이 독립적인 인자였다[P<0.001, OR=7.286(2.663~19.932)]. HBeAg의 혈청소실은 혈청 알부민치와 혈소판 수치가 낮은 경우, 혈청 AST치가 높은 경우, 간경변을 동반한 경우와 초기바이러스반응이 있는 경우에 빈번하게 발생하였고, 혈청 알부민[P=0.041, OR=0.232(0.057~0.945)]치와 초기바이러스반응[P=0.005, OR=7.017(1.799 27.378)]이 독립적인 예측인자였다.



결론: 엔테카비어는 만성 B형간염의 초치료 환자에서 우수한 치료반응을 보였으며, 치료 3개월째 초기바이러스반응은 HBV DNA 음전 및 HBeAg 소실의 독립적 예측인자였다.
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dc.description.abstractBackground/Aims: Entecavir is a potent and selective guanosine analogue that has demonstrated a significant antiviral efficacy against hepatitis B virus (HBV). The aim of this study was to characterize the response to entecavir and to examine the factors affecting that response.



Methods: We administered 0.5 mg of entecavir once daily for more than 12 months to 114 naive chronic hepatitis B (CHB) patients. We measured the levels of liver enzymes, serological markers, and serum HBV DNA at 3-month interval.



Results: Normalization of serum alanine aminotransferase levels was observed in 68.5% (76/114), 74.6% (85/114), and 81.6% (62/76) of patients after 6, 12, and 24 months of therapy, respectively. HBV DNA levels of <50 copies/mL (as evaluated by polymerase chain reaction) were observed in 43.9% (50/114), 71.1% (81/114), and 85.5% (65/76) of patients after 6, 12, and 24 months, respectively. Viral breakthrough was not observed. The rates of HBeAg loss and seroconversion were 43.5% (27/62) and 14.5% (9/62), respectively, after 12 months of therapy, and 56.4% (22/39) and 15.4% (6/39) after 24 months. The independent factor associated with PCR negativity was early virologic response (EVR; HBV DNA <2,000 copies/mL after 3 months of therapy, P<0.001). The independent factors predicting HBeAg loss were found to be serum albumin levels (P=0.041) and EVR (P=0.005).



Conclusions: Entecavir induced excellent biochemical and virologic responses in naive CHB patients. EVR was an independent factor for predicting HBV PCR negativity and HBeAg loss.
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dc.language.isoko-
dc.titleClinical efficacy of entecavir therapy and factors associated with treatment response in naive chronic hepatitis B patients-
dc.title.alternative초치료 만성 B형간염 환자에서 엔테카비어 치료반응 및 관련 인자-
dc.typeArticle-
dc.identifier.urlhttp://www.e-cmh.org/journal/view.php?number=3537-
dc.subject.keyword엔테카비어-
dc.subject.keywordB형간염-
dc.subject.keyword치료반응-
dc.subject.keyword예측인자-
dc.subject.keywordEntecavir-
dc.subject.keywordHepatitis B-
dc.subject.keywordTreatment response-
dc.subject.keywordPredicting factor-
dc.contributor.affiliatedAuthor정, 재연-
dc.contributor.affiliatedAuthor조, 성원-
dc.type.localJournal Papers-
dc.citation.titleThe Korean journal of hepatology-
dc.citation.volume15-
dc.citation.number4-
dc.citation.date2009-
dc.citation.startPage446-
dc.citation.endPage453-
dc.identifier.bibliographicCitationThe Korean journal of hepatology, 15(4):446-453, 2009-
dc.identifier.eissn2093-8047-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
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