拉米夫定联合阿德福韦酯治疗恩替卡韦初治无应答慢性乙型肝炎1例

Lamivudine combined with adefovir dipivoxil for treating entecavirrefractory chronic hepatitis B:one case report

摘要:

目的探讨对恩替卡韦耐药慢性乙型肝炎患者的治疗策略。方法对1例恩替卡韦初治无应答的慢性乙型肝炎患者采取拉米夫定和阿德福韦酯联合应用的治疗策略，并对其病毒学（HBV DNA）和血清学（ALT）指标进行连续追踪和记录。结果经过1年时间的拉米夫定和阿德福韦酯联合抗病毒治疗，该患者的血清HBV DNA载量由换用该治疗策略时的2.02×108 IU/mL下降至1.19×103 IU/mL，血清ALT也恢复至正常水平（≤40 U/L）。结论拉米夫定和阿德福韦酯联合应用对该例恩替卡韦耐药的慢性乙型肝炎患者有效，但能否推而广之仍需深入研究。

Abstract:

ObjectiveTo explore the treatment strategy for entecavirrefractory chronic hepatitis B (CHB) patients.MethodsOne entecavirrefractory CHB patient was switched to combination treatment of lamivudine with adefovir dipivoxil, and levels of HBV DNA and serum alanine transaminase (ALT) were followed up.ResultsAfter one year combined treatment , patient’s serum HBV DNA level dropped to 1.19×103IU/mL from the initial top of 2.02×108IU/mL and ALT level was recovered to normal range (≤40 U/L). ConclusionThe combination use of lamivudine with adefovir dipivoxil is effective for this entecavirrefractory CHB patient , but whether the treatment can be popularized needs to be further investigated.