Anti-hepatitis B virus treatment guided by long-term virus kinetics stepwise tracing

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Anti-hepatitis B virus treatment guided by long-term virus kinetics stepwise

tracing

Authors: Yang, Jin; Cai, Ting; Lou, Guo-Qiang1

Source: Journal of Gastroenterology and Hepatology, Volume 24, Number 6, June

2009 , pp. 1008-1016(9)

Publisher: Blackwell Publishing

Abstract:

Background and Aims: 

Biphasic modeling of viral kinetics provided valuable information to rapidly

assess potential antiviral regimens during the beginning of therapy, but has not

been performed over the long term.

Methods: 

In 11 chronic hepatitis B patients with lamivudine treated per day, the model

with delay time was applied to examine phase transition and analyze viral

kinetics parameters.

Results: 

Viral decay conformed to a biphasic mode during the first 4 weeks, with the

complex profile appeared in the later period. Lamivudine treatment resulted in a

mean log hepatitis B virus (HBV)-DNA decline of 1.77 ± 0.55 after 4 weeks

and 3.79 ± 1.70 log after 24 weeks. The median effectiveness of

blocking viral replication was 96% (range, 89-99%). The median rate of free

virus clearance and infected cell loss was 1.1/day and 0.03/day, respectively.

Through phase transition determination and stepwise modeling process, viral

kinetics were evaluated for complex decay profile during long-term therapy.

Moreover, with the abnormal kinetics tracked, an occasion of add-on combined

therapy was developed to treat patients with emerging virus mutants.

Conclusion: 

The present study using mathematical modeling of viral decay may be a useful

approach to evaluate optimal individualized therapy for HBV infection in a

continuous long-term manner.

Keywords: adefovir; hepatitis B virus DNA; lamivudine; viral dynamics;

tyrosine-methionine-aspartate-aspartate (YMDD) mutant

Document Type: Research article

DOI: 10.1111/j.1440-1746.2008.05759.x

Affiliations: 1: Department of Infectious Diseases, School of Medicine, Hangzhou

Sixth Hospital, Zhejiang Chinese Medical University, Hangzhou, China