Does current situation of second liver cure know a few?

American Hollinger reports, second liver virus is shown global distributing, according to statistic, there is the person that 350 million HBV is carried chronically about on the world. Have the disease that 1 million person causes at HBV to death every year about. The target of effective treatment is: ① restrains virus to duplicate to reduce semiotic; ③ to relieve inflammation with ② of cleared virus; , improve ④ of liver function; to prevent progress to be liver cirrhosis and ⑤ of; of liver cell cancer to raise the patient's survival rate. At present a lot of treat the method of chronic hepatitis B, include factor of disease-resistant bane, immunity adjustment, cell, fight fiber to change, turn over acid of justice few nucleotide, nucleus enzymatic etc. Treat effective definition to be, detect with blame PCR technology, HBV DNA from inside blood abiding and cleared, HBeAg shade turns, appear fight HBe, ALT value falls it is normal to come. Should affect by duplicate period turn when be conformity period, normally ending is to alleviate and rather than is cured. Be in the United States, interferon and rummy husband are the remedy that at present only approval uses at treating second liver surely. An assemble of 15 research analyses interferon recently, evaluated the curative effect of interferon. Contrast with what did not treat group of photograph comparing, HBsAg shade turns rate is high 6% , HBeAg shade turns rate is high 21% . HBV DNA shade turns rate be 1.5 ～ 30.0pg/ml for 20%(detection threshold or 1 million copy of 50 ～ / Ml) . If detect with PCR, criterion HBV DNA shade turns rate general is reduced. Interferon is daily 5MU or 10MU are weekly 3 or tertian it is better remedial program 1. Cure forecasts factor effectively is bear of the virus before cure the amount is small (HBV DNA80% . If lengthen rummy husband to treat time surely (> 6 months) , have 15% ～ the patient HBV YMDD of 30% nod occurrence mutation, this brings about rummy husband to decide curative effect to drop. Decide to rummy husband effective had better forecasting factor is prep above of level of base line ALT normal value upper limit double, and the curative effect of ALT normal patient is not compared contrast the team is good. HBV DNA level is not HBeAg shade those who turn forecast factor, treat HBV DNA of the 20 patients inside week to fall to 10 thousand copy / Ml is the following person, effective possibility is larger. Optimal dosage is 100mg/ day, although larger dose (300mg/ day) can make HBV DNA drops faster, but treat 3 ～ after 6 months, HBV DNA cleared rate and HBeAg shade turn rate is similar. One Xiang Yazhou's research shows, the period of treatment that lengthens rummy husband to decide comes 3 years, can make HBeAg shade turns rate litre to 65% . In treating a few research in the near future jointly, interferon (10MU) is weekly 3, in all 16 weeks, jialamifu decides daily 100mg, 24 weeks, businesslike amount to 29%; to be compared to it, what sheet uses a kind of drug is businesslike for 18% ～ 19% , but difference does not have statistical significance. Instead acid of nucleotide of justice few to oxigenate and nucleus are enzymatic turn over acid of nucleotide of justice few to oxigenate to pass the positive and negative in HBV DNA justice cross is formed between two catenary, and the expression that block breaks gene. Recently one studies in, turn over acid of nucleotide of justice few to oxigenate to make of Pekin duck DHBV duplicate to be restrained for a long time with gene expression. Nuclear enzymatic delegate restrains the mechanism of another kind of element with duplicate virus, they are to turn over acerbity activator of nucleotide of justice few to oxigenate, latter is locating especially bit of cut RNA. The clinical lapse to that HBV of immune adjustment acute affects relies on the quality that host disease-resistant poison reacts and intensity, say exactly, affecting the HBV inside liver cell may be by lymphocyte of cellular noxiousness T (CTL) is cleared, its are likely the mechanism is: CTL of ① antigen activation kills HBV directly, bring about infection liver cell to destroy; ② CTL to secrete cellular factor (IFN- γ and TNF- α ) through be not cytolysis means cleared HBV brings about virus to destroy (do not destroy liver cell) , convey the HBV inside cell of cleared and many liver with gene through restraining virus to duplicate. Be able to bear or endure the immunity with the general and rather than that sufferring is virus particularity is restrained. Ⅰ of CD8+ of a lot of experimental research clew, MHC CTL can keep clear of from inside the cell of infection virus. Accordingly, antigen of HBeAg of usable T cell decides bunch vaccine treats the person that chronic HBV is affected. Thymus element α - 1 can increase inside α of source sex IFN- and γ level, at the same time also heighten IL-2, it still can increase IL-2 to get the expression of body, the hyperplasia that enhances CD3, CD4, CD8 and NK cell and active. In the duck liver cell that infects HBV, thymus element α - 1 what can reduce virus it seems that is duplicate, special the level is conveyed in virus protein. Its security is very good, but need subcutaneous injection. Integrated 4 research make clear as a result, 183 patients treat 6 months (1.6mg is weekly 2) hind the patient HBeAg of 36% and HBV DNA turn shade, ALT falls it is normal to come. Under photograph comparing, 111 are not treated contrast group patient only the patient of 19% is effective. (the exercitation edits: Plum apricot)