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著者: Fukiko Mitsui, Masataka Tsuge, Takashi Kimura, Shosuke Kitamura, Hiromi Abe, Hiromi Saneto, Tomokazu Kawaoka, Daiki Miki, Tsuyoshi Hatakeyama, Nobuhiko Hiraga, Michio Imamura, Yoshiiku Kawakami, Hiroshi Aikata, Shoichi Takahashi, C Nelson Hayes, Harue Igarashi, Kentaro Morimoto, Masao Shimizu, Kazuaki Chayama
雑誌名: Antimicrob Agents Chemother. 2010 Aug;54(8):3205-11. doi: 10.1128/AAC.01372-09. Epub 2010 May 24.
Abstract/Text
Lamivudine (LMV)-adefovir pivoxil (ADV) combination therapy suppresses the replication of LMV-resistant hepatitis B virus (HBV), although its efficacy in suppressing HBV varies among patients. This study analyzed the clinical, virological, and pharmaceutical factors that influence the effect of the combination therapy. Patients negative for hepatitis B virus e antigen (HBeAg) and with low HBV DNA titers immediately prior to the combination therapy effectively cleared serum HBV DNA (P=0.0348 and P=0.0310, respectively). The maximum concentration of ADV in serum (ADV Cmax) was higher in patients who showed HBV DNA clearance (P=0.0392), and the cumulative clearance rates of HBV DNA were significantly higher in patients with ADV Cmax equal to or greater than 24 ng/ml (P=0.0284). HBeAg negativity and lower HBV DNA at the start of the combination therapy and higher ADV Cmax were found to be independent factors for serum HBV DNA clearance. Serum creatinine increased significantly during the combination therapy, and the ADV Cmax was higher in patients with low creatinine clearance rates. In conclusion, higher serum concentrations of ADV are associated with a good response to therapy based on clearance of HBV DNA in serum. However, care should be taken to prevent worsening of renal function due to high ADV serum concentrations.
PMID 20498322 Antimicrob Agents Chemother. 2010 Aug;54(8):3205-11. doi: 10.1128/AAC.01372-09. Epub 2010 May 24.
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