http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Comparison of Efficacy of Tenofovir and Entecavir in Chronic Hepatitis B Patients with High HBV DNA
( Hongkeun Ahn ),( Yoon Jun Kim ),( Hyeki Cho ),( Young Youn Cho ),( Minjong Lee ),( Jeong-ju Yoo ),( Yuri Cho ),( Dong Hyeon Lee ),( Eun Ju Cho ),( Jeong-hoon Lee ),( Su Jong Yu ),( Jung-hwan Yoon ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
Background and Aim: High Hepatitis B Virus (HBV) DNA is associated with increased risk of cirrhosis and hepatocellular carcinoma in chronic hepatitis B patients. There are few studies comparing the efficacy of tenofovir disoproxil fumarate (TDF) and entecavir (ETV) in patients with high HBV DNA. This study aimed to evaluate the efficacy of TDF and ETV in chronic hepatitis B patients with high HBV DNA. Methods: We conducted a retrospective analysis of data from 135 consecutive chronic hepatitis B patients with high HBV DNA titers (≥108 IU/mL). We included nucleos(t)ide analogue (NA) treatment-naive patients or NA-experienced patients without detectable genotypic resistance. 54 patients were treated with TDF and 81 were treated with ETV. Complete virologic response (CVR) rate in two groups was analyzed by Kaplan-Meier curve analysis and Cox proportional hazards model. Results: The median duration of follow-up was 16.6 months. The median time to CVR was 12.8 and 18.8 months in TDF group and ETV group, respectively (p=0.025 by log-rank test). In multivariate analysis, TDF group had significantly higher probability of CVR (hazard ratio [HR]= 1.64, 95% confidence interval [CI]=1.04-2.62; p=0.033) after adjustment for age, HBeAg status, and previous NA experience. The cumulative probability of HBeAg loss was not significantly different between two groups (p=0.163 by log-rank test). None of the patients had discontinued medication due to adverse reactions and GFR at each time point was not significantly different in two groups (p=0.106 by linear mixed model). Conclusions: Tenofovir disoproxil fumarate is superior to entecavir in achieving complete virologic response in chronic hepatitis B patients with HBV DNA greater than 108 IU/mL.
( Hyeki Cho ),( Hongkeun Ahn ),( Yoon Jun Kim ),( Young Chang ),( Joon Yeul Nam ),( Young Youn Cho ),( Seong Hee Kang ),( Eun Ju Cho ),( Jeong-hoon Lee ),( Su Jong Yu ),( Jung-hwan Yoon ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: High Hepatitis B Virus (HBV) DNA is associated with increased risk of cirrhosis and hepatocellular carcinoma in chronic hepatitis B patients. There are few studies comparing the efficacy of tenofovir disoproxil fumarate (TDF) and entecavir (ETV) in patients with high HBV DNA. This study aimed to evaluate the efficacy of TDF and ETV in chronic hepatitis B patients with high HBV DNA. Methods: We conducted a retrospective analysis of data from 189 consecutive chronic hepatitis B patients with high HBV DNA titers (≥10(8) IU/mL). We included nucleos(t)ide analogue (NA) treatment- naive patients or NA-experienced patients without detectable genotypic resistance. 95 patients were treated with TDF and 94 were treated with ETV. Complete virologic response (CVR) rate in two groups was analyzed by Kaplan-Meier curve analysis and Cox proportional hazards model. Results: The median duration of follow-up was 15.5 months. The median time to CVR was 12.8 and 18.0 months in TDF group and ETV group, respectively (P=0.011 by log-rank test). In multivariate analysis, TDF group had significantly higher probability of CVR (hazard ratio [HR]=1.72, 95% confidence interval [CI]=1.16-2.56; P=0.007) after adjustment for age, HBeAg status, aminotransferase and previous NA experience. The cumulative probability of HBeAg loss was not significantly different between two groups (P=0.210 by log-rank test). None of the patients had discontinued medication due to adverse reactions and GFR at each time point was significantly different in two groups (P=0.003 by linear mixed model). Conclusions: Tenofovir disoproxil fumarate is superior to entecavir in achieving complete virologic response in chronic hepatitis B patients with HBV DNA greater than 10(8) IU/mL.
Trimethoprim-sulfamethoxazole에 대해 지연성 과민반응을 보인 환자에서 성공적인 급속 탈감작 치료 사례 1예
윤도란 ( Doran Yoon ),안홍근 ( Hongkeun Ahn ),김세용 ( Se Yong Kim ),황성준 ( Seong Jun Hwang ),박한기 ( Han Ki Park ),강혜련 ( Hye Ryun Kang ) 대한천식알레르기학회(구 대한알레르기학회) 2015 Allergy Asthma & Respiratory Disease Vol.3 No.2
Trimethoprim-sulfamethoxazole (TMP-SMX) is an antibiotic used for the treatment or prophylaxis of Pneumocystis pneumonia and other infectious conditions. Sulfonamide derivatives have been reported to cause delayed hypersensitivity reactions, resulting in switch to less effective second-line antibiotics. Although desensitization is traditionally known to be effective in patients with imme¬diate hypersensitivity, it is also applied to the treatment of delayed hypersensitivity in recent years. A 66-year-old female who had a history of repeated TMP-SMX-induced delayed hypersensitivity presenting as whole body rashes needed to take prophylactic dose of TMP-SMX (80/400 mg daily) before initiation of chemotherapy for multiple myeloma. Intravenous rapid desensitization was per¬formed by using a 11-step, 4-bottle protocol from 1:1,000 to 1:1 solution for 3 hours to reach the target dose for prophylaxis. After successful rapid desensitization of TMP-SMX, 1-month prophylaxis was completed without any complications until the patient re-covered normal immunity. We herein reported a case of delayed hypersensitivity reaction to TMP-SMX in an about-to-be immuno¬compromised host with planned chemotherapy who successfully completed 1-month prophylaxis with the drug without any com¬plications through rapid desensitization.(Allergy Asthma Respir Dis 2015;3:155-158)
( Joon Yeul Nam ),( Jeong-hoon Lee ),( Jieun E Kim ),( Dong Hyeon Lee ),( Young Chang ),( Hongkeun Ahn ),( Hyeki Cho ),( Jung-ju Yoo ),( Minjong Lee ),( Young Youn Cho ),( Eunju Cho ),( Su Jong Yu ),( 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: Regular surveillance for hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients is essential to detect HCC earlier and to improve prognosis. This study investigated whether prescription of oral medication contributes to adherence to surveillance, early tumor detection, and overall survival (OS). Methods: A total of 401 CHB patients who were newly diagnosed with HCC were included: 134 patients received no medication (group 1), 151 received hepatoprotective agents such as ursodeoxycholic acid and silymarin (group 2), and 116 received antiviral agents (group at two years before HCC diagnosis. The primary endpoint was OS, and secondary endpoints were compliance to regular surveillance and HCC status at diagnosis. Results: Compared to group 1, both group 2 and 3 had higher rates of good compliance to regular surveillance (defined as participation >80% of imaging intervals being ≤6 months) (58.2%, 90.1%, and 97.4%, respectively; P<0.001), more HCC diagnosed at a very early stage (20.9%, 32.5%, and 36.2%; P=0.019) and smaller tumor size (2.8±2.4cm, 1.9±1.1cm, and 1.8±0.9cm; P<0.001). Finally, compared to group 1, both group 2 (hazard ratio, 0.63; 95% confidence interval, 0.41-0.97; P=0.035) and group 3 (hazard ratio, 0.40; 95% confidence interval, 0.22-0.71; P=0.002) had significantly longer OS Figure 1). In mediation analysis, prolonged OS is resulted considerably from indirect effect mediated by shorter imaging interval (>100% in group 2 and 14.5% in group 3) rather than direct effect of medication itself (Figure 2). Conclusions: Prescription of oral medication improves compliance to surveillance and enables early detection of HCC, which is finally associated with enhanced survival.
Lee, Yun Bin,Jung, Eun Uk,Kim, Bo Hyun,Lee, Jeong-Hoon,Cho, Hyeki,Ahn, Hongkeun,Choi, Won-Mook,Cho, Young Youn,Lee, Minjong,Yoo, Jeong-Ju,Cho, Yuri,Lee, Dong Hyeon,Cho, Eun Ju,Yu, Su Jong,Park, Sung J American Society for Microbiology 2015 Antimicrobial Agents and Chemotherapy Vol.59 No.2
<P>Tenofovir disoproxil fumarate (TDF) monotherapy is a therapeutic option for chronic hepatitis B (CHB) patients infected with hepatitis B virus (HBV) variants resistant to lamivudine (LAM). We evaluated the antiviral efficacy and safety of TDF alone compared to those of TDF plus LAM or telbivudine (LdT) combination in patients harboring HBV variants with genotypic resistance to LAM. This multicenter retrospective study included consecutive patients who had LAM-resistant HBV variants and were treated with TDF alone (monotherapy group) or TDF combined with LAM or LdT (combination therapy group) for at least 6 months. Inverse probability of treatment weighting (IPTW) for the entire cohort was applied to control for treatment selection bias. Overall, 153 patients (33 in the monotherapy group and 120 in the combination therapy group) were analyzed. The overall probability of achieving complete virologic suppression at month 12 was 91.6%: 88.6% in the monotherapy group and 92.6% in the combination therapy group. Combination therapy was not superior to monotherapy in viral suppression before and after IPTW (<I>P</I> = 0.562 and <I>P</I> = 0.194, respectively). Hepatitis B e antigen (HBeAg) loss, biochemical response, and virologic breakthrough did not differ between treatment groups. The probabilities of complete virologic suppression were comparable between treatment groups in the subsets according to HBeAg status and HBV DNA levels at baseline. No patient experienced any significant renal dysfunction during the treatment period. In conclusion, TDF monotherapy has antiviral efficacy comparable to that of TDF plus LAM or LdT combination therapy, with a favorable safety profile in CHB patients with LAM-resistant HBV variants.</P>