Comparison of Hepatitis B Virus DNA, RNA, and Core Related Antigen as Predictors of Lamivudine Resistance in Patients with Chronic Hepatitis B
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概要
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The clinical usefulness of hepatitis B virus (HBV)DNA, RNA, and core related antigen (HBcrAg)assaysfor predicting the appearance of HBV DNA breakthrough was evaluated and compared in patients withchronic hepatitis B undergoing lamivudine therapy.Methods :Thirty six patients with chronic hepatitis B whoreceived lamivudine therapy for more than 1 year were enrolled. HBV RNA was measured simultaneouslywith HBV DNA (HBV RNA/DNA) using a real-time detection polymerase chain reaction assay with apreceding step of reverse-transcription. HBV DNA was measured by an HBV AMPLICOR monitor kit.HBcrAg was measured using a chemiluminescence enzyme immunoassay. Results : Sixteen patients (44%)developed HBV DNA breakthrough during the median observation period of 48.4 months (range 7.4-87.8months). Afterwards, HBV DNA breakthrough was prospected using the three parameters taken 6 monthsafter starting lamivudine therapy. The cut-offlevels for predictions were determined by receiver operatingcharacteristic curves, and were 2.6 log copies/ml for HBV DNA, 3.8 log U/ml for HBV RNA/DNA, and 4.0log U/ml for HBcrAg.Sensitivity,specificity,and accuracy for predicting HBV DNA breakthrough were 25%,100%,and 67% respectively for HBV DNA.Similarly,they were 50%,90%,and 72% for HBV RNA/DNA,and 100%, 40%, and 67% for HBcrAg. Conclusion : Our findings confirm that HBV DNA is useful foridentifying patients who are at high risk for HBV breakthrough.HBcrAg is useful for isolating those who areat low risk, and HBV RNA/DNA showed predictive characteristics similar to HBV DNA with highersensitivity and the highest accuracy
- 2010-08-10
著者
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Umemura Takeji
信州大学 医学部内科学
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Maki Noboru
Advanced Life Science Institute Inc.
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Tanaka Eiji
Shinshu Univ. School Of Medicine Matsumoto Jpn
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OTA Masao
Department of Legal Medicine, Shinshu University School of Medicine
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Takeda Naokazu
Department Of Gastroenterology Shinshu University School Of Medicine
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Matsumoto Akinori
Third Department Of Internal Medicine Asahikawa Medical College
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Umemura Takeji
Department Of Gastroenterology Shinshu University School Of Medicine
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Matsumoto Akihiro
Department Of Gastroenterology Shinshu University School Of Medicine
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Yoshizawa Kaname
Department Of Gastroenterology Shinshu University School Of Medicine
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Umemura Takeji
信州大学 医学部病態解析診断
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Joshita Satoru
Department Of Gastroenterology Shinshu University School Of Medicine
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Matsumoto Akihiro
Department Of Medicine Shinshu University School Of Medicine
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Tanaka E
Department Of Medicine Shinshu University School Of Medicine
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Joshita Satoru
Department of Legal Medicine, Shinshu University School of Medicine
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