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학술저널
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대한소아소화기영양학회 Pediatric Gastroenterology, Hepatology & Nutrition Pediatric Gastroenterology, Hepatology & Nutrition 제11권 제2호
발행연도
2008.1
수록면
137 - 142 (6page)

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Purpose: Interferon is a widely used treatment for chronic hepatitis B in children. However, additional treatment options are needed because more than 50% of hepatitis B patients are unresponsive to interferon. Although lamivudine is widely used to treat hepatitis B, there are few studies on the effect of lamivudine in hepatitis B patients unresponsive to interferon. Methods: Eight interferon unresponsive patients (6 males and 2 females) were treated with lamivudine (3 mg/kg/day, maximum 100 mg/day) from 6∼12 months after interferon treatment was discontinued among 33 children with chronic hepatitis B. They were treated with interferon (interferon α-2b, 10 MU/m2 or pegylated interferon 1.5μg/kg) for 6 months from January 2000 to December 2007 at the Pusan National University Hospital. The medical records were analyzed retrospectively. Results: The age at treatment with interferon and lamivudine was 4.9±3.1 and 6.1±3.2 years, respectively. The serum ALT level before treatment with interferon was 148.1±105.8 IU/L and the log HBV-DNA PCR mean value was 6.95±0.70 copies/mL. The serum ALT level after treatment with interferon was 143.1±90.4 IU/L and the log HBV-DNA mean PCR value was 6.46±2.08. HBeAg negativization occurred in 2 patients. For all patients, normalization of the serum ALT levels and HBeAg seroconversion (except 2 patients with HBeAg negativization) occurred at 7.4±2.1 and 7.9±2.1 months respectively after lamivudine treatment. The HBV-DNA PCR became negative in 7 patients (87.5%) at 2.4±2.8 months. Complete response was achieved in 7 patients and no recurrence was observed in 2 patients for 3 years after the completion of treatment. Five patients are still under treatment for a mean treatment duration of 24.4±9.1 months. In one patient, viral breakthrough occurred and the treatment was stopped. Conclusion: The number of patients was small, however, lamivudine treatment in patients with chronic hepatitis B who were unresponsive to interferon was highly effective.
#Hepatitis B #Children #Lamivudine #Interferon #Non-responder

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참고문헌 (20)

참고문헌 신청
/ 2000 / Consensus statements on the prevention and management of hepatitis B and hepatitis C in the Asia-Pacific region. Core Working Party for Asia-Pacific Consensus on He google schola Boni C / 1998 / Pilli M, Urbani S, et al. Lamivudine treatment can restore T cell responsiveness in chronic hepatitis B / J Clin Invest 102 : 968 ~ 975 google schola Choe BH / 2007 / Long-term therapeutic efficacy of lamivudine compared to interferon-alpha in children with chronic hepatitis B: the younger the better / J Pediatr Gastroente google schola Dienstag JL / 1999 / Lamivudine as initial treatment for chronic hepatitis B in the United States / N Engl J Med 341 : 1256 ~ 1263 google schola Dikici B / 2002 / Davutoglu M, Yagci RV, et al. Comparison of treatments of chronic hepatitis B in children with lamivudine and alpha- interferon combination and alpha-inter google schola

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