"Physicians! How to do? I is not no
hope!"
"After
a couple of months GOT GPT, or so high! What to do? Will
cirrhosis?"
"There is
nothing better drugs? Own expense to buy it does not matter!" Wong said
terrified.
No wonder he was nervous
in his early forties, kids on the country, the business have the will, the
economy is also no pressure, everything seems to have a better life, to carry
out. Turns
hepatitis B source for many years, has recently given up the attack, although no
jaundice, liver function index continued to beat in four five hundred, people
also feel tired. Tried
a lot of Chinese and Western medicine, serving a variety of liver slices, liver
medicine, still can not solve the problem, how does Xinjinin Rufen
him.
Taiwan's
chronic hepatitis B patients with nearly twenty percent of the original,
although due to the implementation of hepatitis vaccinations, reducing the
infection rate of the younger generation, but in this island there are about
three million carriers, these people did
not dare hope for a cure for this disease can really approach appears.
There is no denying, for the
treatment of hepatitis B, and now is still quite disappointing. But while no
cure for the drug, the use of interferon or provide a reduced hepatitis B
inflammation, increasing e antigen reversal disappeared, prompting the emergence
of e antibody. Unfortunately, this
method can only be treated with interferon given by injection, but also a lot of
side effects, the price is too high, in this era of economic downturn, people
pay more inhuman up. Now, however, have a new
choice! U.S. Food and Drug
Administration (FDA) in 1998 end of the year to send a Christmas gift!
Approved
lamivudine to treat hepatitis B "lamivudine is generic trade name Epivir HBV,
referred to 3TC," will soon also introduce domestic pharmaceutical companies in
Taiwan are also doing market research, and packaging design. Taiwan's Department of Health were also waiting for
approval now!
Before using the new drugs, but
also need to know more about what this lamivudine, the saying goes, is a drug
that is poisoning must! lamivudine
oral dosage form is a drug, Chinese product name is unknown, first it is a drug
used to treat AIDS, AIDS patients was noted that associated with hepatitis B,
the receiving lamivudine, its serum hepatitis B virus is also decreased, liver
inflammation eased, so
medical research institutions in the formal study of it is used to treat
hepatitis B.
Its role
lamivudine few turns, the intervention by the hepatitis B virus polymerase,
resulting interrupt viral DNA synthesis, inhibition of reverse transcriptase.
While the
mammalian α, β, γ, etc. are weak inhibitor of polymerase, so little effect on
other cells in the human body. Live
animal model experiments in the past; ducks and apes found the duck hepatitis B
after giving two weeks lamividine reduce their viral concentrations seen after
stopping its rise to four days. Hepatitis B infection apes give drugs also have
similar results. lamivudine
has good oral absorption rate, the medication within 0.5 to 2 hours up to the
highest concentration of drug absorption and ingestion of food, it can be taken
before and after eating, the United States has solution and tablet dosage form,
they can reach the same concentration of blood, mutually replaced. Volume of
distribution independent of dose and body weight, and protein binding is low,
less than 36%. Most
of its metabolites in urine as unchanged in row, only about 4.2% metabolized to
trans-sufoxide. As excreted by the
kidneys and kidney dysfunction are required to adjust its dose. Abnormal liver function does not need to change the
dose.
In human
trials, pharmaceutical companies official reports, the treatment of hepatitis B
100mg daily is the currently recommended dose is AIDS patients taking this drug
dose third. After
treatment of hepatitis B patients with symptoms of liver function will improve
about fifty-six%, placebo hepatitis patients only 25%, HBeAg disappearance rate
of 15-17%, compared to the naturally disappear inverted green high, but the effect of interferon alone for six
months or less. The Chinese University
of Hong Kong study has similar conclusions. Using the combined effect of other
viral infections, such as a merger with C or D virus infection, yet to
report.
On
drug prices concerned, it was reported in patients with hepatitis B in the
United States daily medication market wholesale value of about 3.41 U.S.
dollars, rather more than one hundred and ten yuan NT, speculate in the Taiwan
market, the retail price may be more than two hundred yuan it! Compared to the cost of interferon, a
lot cheaper, may also be compared to some of betel family to spend a day also
save some.
So far it
seems pretty good understanding, but there are some considerations: a history of
allergy to be careful. Lactic acidosis and severe hepatomegaly
and cholestasis who must also be careful to use these drugs had fatal cases.
Before any use of
lamivudine AIDS should a priori, because therapeutic concentration is lower than
in the treatment of AIDS. Want
to take lamivudine in patients with hepatitis B, preferably before treatment and
had an HIV virus detection in order to avoid infection with HIV do not know, but
after long-term low dose lamivudine, resulting in HIV drug resistance, which
problem in Taiwan, although
not important, still have to be careful, after all AIDS patients has been
increasing. In addition, some
cases may be due to withdrawal, liver function deteriorates, the withdrawal to
be careful. Pancreatitis also use cases.
Other side effects include
nausea, vomiting, diarrhea, anemia, hepatomegaly, blood lactic acid buildup.
Also no experience in
children and pregnant women, single full of drugs in pregnancy, it belongs to
C-level classification.
It
must also be emphasized, lamivudine still can not really cure for hepatitis B,
but it can inhibit the hepatitis B virus reverse transcriptase enzyme,
inhibiting its reproduction, reduce inflammation of liver cells, effective
restoration of hepatitis B patients with liver function. As for its future, the impact of cirrhosis
and liver cancer or prevention, then no assessment report. Currently recommended medication time of
the year, but taking a year later, and then taking the withdrawal or how long?
If abnormal liver function after
stopping, the medical community has not yet been concluded. Compared with interferon alone, or in combination
of effects, but also to be assessed. Some
of this gene has also been noted that the use of lamivudine after some of the
hepatitis B virus and resistant mutation, which Polymerase mutated, amino acid
sequence, (position 522) YMDD becomes a methionine or valine isoleucine, or
(positive 528) leucine replaced by
methionine. There
YMDD mutant hepatitis B, compared with wild-type HBV replication force a bit
weak, but also poor sensibility for lamivudine, lamivudine using the longer the
mutation rate is also higher. The clinical
significance of these mutations is not yet known.
In short, the emergence of
new drugs or new therapies, the total gives infinite hope, but glad I also need
to understand its true role, and treatment limits. Perhaps it solves one part of the question,
will bring more problems in it? This article
can not answer it.
A few days ago, Mr. Wong
pipeline through which I do not know, through friends in the United States back
to lamivudine in taking! Drugs made
diamond shape, looks like a white Viagra. Remind him of drug side effects, liver
function need to continue follow-up examinations, and then pray useful for the
treatment!
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