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심포지엄 1 : 간세포 손상 ; 바이러스에 의한 간 손상
조몽 대한소화기학회 2003 대한소화기학회 춘계학술대회 Vol.2003 No.-
급성 간염에서 대부분의 HBV는 임상 증상이 나타나기 전 선천면역 혹은 초기의 입양면역 반응에 의해 제거되며 간염의 임상양상과 간 손상은 항원에 비특이적인 세포의 간 내 침윤 및 증폭에 의해 일어난다. HBV는 종종 숙주의 면역반응을 회피하여 만성 간염을 야기하며 급성 간염 환자에서 HBV 특이적인 세포가 격렬하고 다클론의 다특이적인 반응을 나타내 세포면역반응의 과잉상태를 보이는 것과 달리 만성 간염 환자에서는 좁은 영역을 겨냥하고 매우 약한 반응을 보
라미부딘 내성 만성 B형간염 환자에서 아데포비어 치료 중 HBV polymerase 의 변이양상
조몽,허정,문재현 부산대학교 병원 암연구소 2006 부산대병원학술지 Vol.- No.20
Purpose: Adefovir dipivoxil (ADV) is a nucleotide analogue that inhibits wild-type hepatitis B virus (HBV) and lamivudine (LMV)-resistant HBV mutants. ADV-resistant mutation has been reported to occur frequently in patients with LMV-resistance. The aim of this study was to evaluate the frequency of ADV-resistant mutations and pattern of mutants in the patients with LMV-resistant chronic HBV infections. Subject and Methods: This study consisted of 124 chronic HBV infected patients who had LMV-resistant HBV mutants. The duration of LMV therapy was 27.5 (±14.0) months, and that of ADV was 26.6 (±6.9) months. Serum HBV DNA was tested by Cobas Amplicor HBV Monitor test (Roche Diagnostics System, Basel, Switzerland). The mutations of the HBV DNA reverse transcriptase/polymerase were tested by direct sequence analysis. Results: The serum HBV DNA level was decreased below 2x10⁴IU/mL (10^(5) copies/mL) in 77.7% and below 2x10² IV/mL (10³ copies/mL) in 42.6% after 12 months of ADV therapy. The median level of serum HBV DNA was 3.3log10 and 3.lloglO at 6 months and 12 months of ADV therapy, which were significantly lower than pretreatment level (6.05log10). The mutant rtN236T developed in 25%, rtA181T/V in 64%, rtV84H in 4%, and rtQ215S in 7% of the patients during 12 months. Conclusions: Although ADV therapy is effective, it leads high rate of mutations of HBV DNA reverse transcriptase/polymeerase in patients with chronic HBV infections who have LMV-resistant HBV mutants.