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oai:repository.ajou.ac.kr:201003/75932024-10-11T02:17:40Zcom_201003_14369com_201003_14368col_201003_14370

Analysis of Treatment Effect of Lamivudine, Adefovir Add-on Therapy in Patients with Lamivudine Resistant Chronic B-viral Hepatitis 라미부딘 내성 만성 B형 간염 환자에 있어 라미부딘과 아데포비어 병용 요법의 치료 효과와 특성 분석 김, 동훈 조, 성원 대학원 의학과 201024229 김, 동훈 만성 B형 간염 라미부딘 내성 아데포비어 바이러스 돌파 Background: Add on adefovir (ADV) to ongoing lamivudine (LAM) is an established treatment modality for treatment of LAM resistance with chronic hepatitis B. We assessed the long?term efficacy (median follow-up of 20.18 months) of ADV add-on LAM therapy in 89 LAM-resistant patients. Methods: 89 patients (29.2% cirrhotics, 76.4% hepatitis B e antigen positive) with LAM resistant patients who were not experienced ADV monotherapy were enrolled, retrospectively from August 2005 to October 2010. All the patients were treated with ADV add-on LAM therapy. Liver function test, hepatitis B virus (HBV) DNA and HBeAg/HBeAb were assessed every 3 months. ADV associated (rtA181T/V and rtN236T) mutations were looked for at intervals in all HBV DNA-positive serum samples, yearly Results: Cumulative ratio of undetectable HBV DNA level (<50 copies/mL or <8.6 IU/mL) at 6 months, 1 year, and 2 years were 15.7%/44.2%/45.4% for HBeAg positive group and 34.8%/39.1%/52.6% in HBeAg negative group. Seroconversion was observed 10.2%/19.7%/23.6% in 6 months, 1 year, and 2 years. Virologic breakthrough phenomenon was seen 1.1%. Conclusions: LAM and ADV combination therapy effectively suppresses HBV replication and prevents virologic and clinical breakthrough in LMV-resistant patients. And emergence of ADV-resistant mutants is rare, at least over a period of 24 months. 국문요약 차례 그림 차례 표 차례 Ⅰ. 서론 1 Ⅱ. 연구대상 및 방법 3 A. 연구대상 3 B. 연구방법 3 C. 통계 4 Ⅲ. 결과 5 A. 대상 환자군의 치료 전 특성 5 B. 치료 반응 6 C. 바이러스 돌파 현상의 관찰 9 D. 유전자형 내성 빈도의 관찰 10 Ⅳ. 고찰 14 Ⅴ. 결론 17 참고문헌 18 ABSTRACT 22 Master 2012-10-31T04:18:09Z 2012-10-31T04:18:09Z 2012 2012 Thesis Theses http://repository.ajou.ac.kr/handle/201003/7593 http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000012181 000000012181 ko