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慢性B肝的新年新希望
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慢性B肝的新年新希望


陳建廷(台北市立中興醫院消化內科醫師) 


 

 肝硬化近幾年蟬聯國人第六大死因,肝癌 也位居國人男性第一大癌症死因及女性第三大 癌症死因。每五位肝癌患者就有四位導因於慢性B型肝炎。國人B肝患者帶原率約為15%,估計全台逾250萬名帶原者,未來可能引起慢性肝炎,再轉成肝硬化,最後變成肝癌。  慢性B肝 有藥救  不過,不必太悲觀!對於國內外慢性B型肝炎患者而言,去年是個充滿豐收的一年!在台灣,自去年健保開始在部分醫院開放慢性B型肝炎治療試辦計畫,包括給付干擾素及新的口服藥物Lamivudine(拉美芙錠,肝安能),為慢性 B型肝炎患者提供了一項阻斷肝硬化及肝癌的新選擇。  在美國,食品藥物管理局 根據去年二月刊登於新英格蘭醫學雜誌的兩篇慢性B型肝炎治療第三期人體試驗報導,核准新的口服藥物Adefov ir上市,為慢性B型肝炎患者提供了一項阻斷服用肝安能產生病毒突變導致抗藥性的第二線新選擇。  肝安能原是研發用來治療愛滋病,後來發現它可抑制B型肝炎病毒的繁殖,對慢性B肝有不錯的療效。根據陳定信院士聯合國內外多家醫學中心長達五年使用肝安能的人體試驗結果,肝安能可成功降低B型肝炎病毒因慢性肝炎,所導致的肝硬化,至於降低肝癌部分,仍需更長期的觀察。  肝安能 干擾素 保肝尖兵  由於肝安能是口服藥,比起干擾素的打針治療,使用上較方便,同時副作用也少。肝安能在目前使用的對象上,對於慢性B型肝炎急性發作的患者,接受免疫抑制劑或化學治療而導致 B型肝炎病毒活化的患者,以及B型肝炎接受肝移殖的患者,是絕對需要的藥物。  至於肝功能皆正常的B型肝炎健康帶原者,基本上除了定期追蹤之外,是不需要接受任何治療的。長期使用肝安能九個月以上,容易產生 B型肝炎病毒突變導致抗藥性,新的口服藥物A defovir在美國上市,為慢性B型肝炎患者提供了一項阻斷服用肝安能產生病毒突變導致抗藥性的第二線新選擇。  疫苗注射有成 帶原率可望銳減  自民國75年政府全面推展新生兒B型肝炎疫苗接種後,母親在生產前後「垂直傳染」給新生兒的可能性已經大為降低。而在避免水平傳染方面,則須注意避免不必要之輸血、打針、針灸、刺青等行為。此外,對於尚未感染過B型肝炎的青少年及成人,則需注射B型肝炎疫苗。  展望新的一年,期待新的口服藥物Adefovir 繼去年在美國成功上市後,也在國內上市,以提供服用肝安能產生病毒突變導致抗藥性的第二線新選擇。  B型肝炎在新生兒全面疫苗注射後,可預見的,將會減少,今年也是第一批全面B型肝炎疫苗注射新生兒滿18歲成年的一年,18歲以下帶原率將小於1%,而尚未接受疫苗注射的成人,建議接受疫苗注射,對於已經是B型肝炎帶原者,則切記必需定期追蹤,以避免肝硬化及肝癌的發生。

【 2004-01-31/中國時報】     

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Dr. Chen, Please response to my renewed data.
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革命烈士韓起的兒子
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Please refer to my article

Michael

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引用網址:http://city.udn.com/forum/trackback.jsp?no=52340&aid=1637477
Thanks for your response
    回應給: mikky(mikkyhan) 推薦0


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Based on my own data, I followed the medicine named
10/25/00  new drup for HBV adefovir
Entecavir was introduced to the mkt/

I talked to Dr. Chen and she told me not good to change from Epivir. Not only because it costs more and the resistance of the body to the new advoir are the quite same. If there is no obvious side effect better stick to Epivir.

I have my blood checked to see if there is any improvement. The on line search engine find another medicine is gone experiment. I will keep an eye on the new development.

Thanks you for your information.

Michael

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引用網址:http://city.udn.com/forum/trackback.jsp?no=52340&aid=1554994
Epivir-HBV 肝安能 8-Year Follow-Up(32).Beat the Odds.
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革命烈士韓起的兒子
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http://city.udn.com/v1/blog/article/index.jsp?uid=mikkyhan

Epivir-HBV 肝安能 8-Year Follow-Up(32).Beat the Odds.瀏覽28|回應0|推薦0
2006/04/05 09:09:21

I thought you couldn’t make it!” Momoir.
 
Part 32. Finally, Beat the Odds. If I can do it, you can do it.
I got antibodies <5 present in year 8. I.E. I have recovered
.
I cannot infect others:
Headline News:
Mariposa, California, March 21,2006, Michael  may be the 1st HB Patient in the world with lab tested Hepatitis Be antibody <5. According to reliable source,  This is a direct result with patient 8 years continuing oral Epivir manufactured by Glaxosmithkline.

 The Lab blood specimen were taken 2/27/2006 and reported 03/01/2006 by the order of Dr. Rose, Robert J conducted by Quest Diagnostics Inc located in John C Fremont Hospital Lab, 5189 Hospital Rd Mariposa CA.95338-9524.

In one article dated 4/10/2000 by Dr, Lai in Hong-Kong says:  
” The implication is that monotherapy with just Epivir-HBV alone will not be the ultimate regimen. Neither is monotherapy with alfa interferon, the other FDA-approved drug to treat chronic hepatitis B. Most studies to date have not shown that the addition of alfa interferon to Epivir-HBV is any better than either alone, and that it contributes a significantly worsened side effect profile.”  

The above conclusion by Dr. Lai is apparently overturned by this discovery of Michael Han’s lab test results.
The above news may cause controversy on the subject matter below:

 1.    The patient has been using 75 mg dosage against Epivir 100 mg created for HBV patient only by GLX.
2.    The 1st application for this patient had no doctor’s prescription for a period of one year.
3.  In clinical trials in Japan as of February 1997, All 11 patients required hospitalization. One patient died.
4. Other clinical trials results through out the world have not been provided by GLX.

Glaxosmithkine has not provided their own secret file for evaluation to the public. Whether there is any scientist suggestion on providing 75 mg for HBV patient clinical trial, its not known. On consideration of increasing corporate revenue, it is quite possible that 100 mg dosage has been adapted for the sore purpose of profitability. (100mg and 150 mg Epivir at same price.)

If you want to check it out your self, here is Glaxo Wellcome's Medical Services Department at (800) 334-0089.

 This is sure an encouraging news not only to the 1.25 millions HB patients in the States but possible 300 millions Patients through out the world. The CNN (approached for comments) learned thru friend related to Michael Han, that this patient has contracted HB in his late 40’s in Taiwan. Although he has searched for a complete cure for years and found there is no in the available market. We found that this is a sign that we might be able to have a breakthrough and See the light at end of tunnel for HB patients.   



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