Abstract

目的 探讨和评价阿德福韦对因拉米呋啶耐药而出现HBV再感染的肝移植病例的抗病毒疗效.方法 9例存在拉米呋啶耐药株的肝移植术后HBV再感染者,治疗组(8例)予以改服阿德福韦酯,对照组(1例)加服泛昔洛韦治疗,并对两组病例的HBV DNA复制、乙肝血清学标志物、肝功、肾功等指标进行定期随访.结果 治疗组6例(75%)于服药后2~3个月均实现HBV DNA的阴转,1例(12.5%)维持低水平状态(103 copies/ml),且各有1例分别实现了HBsAg的阴转和HBeAg/HBeAb的血清学转换,肝功能均明显改善.对照组治疗前后各项指标无明显变化.结论 对拉米呋啶耐药而导致的HBV再感染的肝移植病人,新一代核苷类药物阿德福韦,能够有效的抑制HBV变异株的复制,改善肝功能。

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