拉米夫定/干扰素-α联合治疗围生期感染乙肝的免疫耐受患儿:一项初步研究

查看全文 作　　者：D'Antiga L.;Aw M.;Atkins M.;G.Mieli-[1]Vergani;王一飞 机构地区：[1]Department of Paediatric Hepatology,Institute of Liver Studies,King's College Hospital,Denmark Hill,London SE5 9RS,United Kingdom Dr. 出　　处：《世界核心医学期刊文摘(儿科学分册)》索引2006年第2卷第8期,共1页 摘　　要：Objective:To investigate whether combining the antiviral effect of lamivudine with the immune-boosting action of interferon-alpha(IFN-α)is effective in treating hepatitis B virus(HBV)“immunotolerant”children.Study design:Twen tythree children(8 boys;mean age,10 years)infected during the first year of life(17 Asian,21 with normal aminotransferase levels,15 with HBV-DNA > 1000 pg/mL by hybridization and all with mild histologic changes)were treated with l amivudine(3 mg/kg)for 8 weeks alone and then lamivudine(3 mg/kg)-and IFN-α(5 MU/m2,3 times weekly)in combination for 10 months.Results:Seventy-eight percent became HBV-DNA negative at the end of treatment,5(22%)seroconverted to anti-HBe,4(17%)of whom achieved complete viral control,becoming persis tently HBsAg negative and anti-HBs positive.None had YMDD mutations.The viral status of the patients has not changed after a median follow-up of 40 months(range,36 to 48).Conclusions:This pilot study suggests that lamivudine pretrea tment followed by a combination of lamivudine and IFN-αcan induce complete vir al control in HBV immunotolerant children,hitherto considered poor responders. 关 键 词：乙肝病毒(HBV) 围生期感染 干扰素-Α 联合治疗 拉米夫定 免疫耐受 患儿 步研究 免疫增强作用 抗病毒效应