Journal of Physiology & Pathology in Korean Medicine (동의생리병리학회지)

The Physiological Society of Korean Medicine and The Society of Pathology in Korean Medicine (대한동의생리학회·한의병리학회)
권호 표지

HBV-DNA Suppression in a Chronic Hepatitis B Patient Treated with Western Medicine Plus Traditional Korean Medicine Combination Therapy

한.양방 협진에 의한 만성 B형 간염 환자에서의 HBV-DNA 감소 증례보고

  • Park, Sung-Ha (Department of Internal Medicine, Pusan National University School of Korean Medicine) ;
  • Park, Seung-Chan (Department of Internal Medicine, Pusan National University School of Korean Medicine) ;
  • Kim, Do-Hyung (Department of Internal Medicine, Pusan National University School of Korean Medicine) ;
  • Kim, So-Yeon (Department of Internal Medicine, Pusan National University School of Korean Medicine) ;
  • Choi, Jun-Yong (Department of Internal Medicine, Pusan National University School of Korean Medicine) ;
  • Han, Chang-Woo (Department of Internal Medicine, Pusan National University School of Korean Medicine)
  • 박성하 (부산대학교 한의학전문대학원 내과학교실) ;
  • 박승찬 (부산대학교 한의학전문대학원 내과학교실) ;
  • 김도형 (부산대학교 한의학전문대학원 내과학교실) ;
  • 김소연 (부산대학교 한의학전문대학원 내과학교실) ;
  • 최준용 (부산대학교 한의학전문대학원 내과학교실) ;
  • 한창우 (부산대학교 한의학전문대학원 내과학교실)
  • Received : 2011.05.31
  • Accepted : 2011.08.01
  • Published : 2011.08.25
Download PDF
⟨ Previous Next ⟩

Abstract

Here we describe a case of lamivudine and entecavir resistant chronic hepatitis B, treated with western medicine plus traditional korean medicine combination therapy. We administered Injinchunggan-Tang(茵蔯淸肝湯), a traditional Korean herb remedy, with entecavir to a 45-year-old chronic hepatitis B patient who didn't have achieved HBV-DNA suppression, in spite of 18 month lamivudine mono therapy and 14 month entecavir mono therapy. HBV-DNA decreased more than one thousandth from 98,100 IU/mL to 53 IU/mL just in 23 days, and resultingly it seems that the combination therapy could be very potent, at least to some chronic hepatitis B patients.

Keywords

References

  1. 신정우 박능화. 만성 B형 간염의 치료. 대한내과학회지 77(3):265-274, 2009.
  2. Lok, A.S., McMahon, B.J. Chronic hepatitis B: update 2009. Hepatology. 50(3):661-662, 2009. https://doi.org/10.1002/hep.23190
  3. Chang, T.T., Gish, R.G., de Man, R., et al. A comparison of entecavir and lamivudine for HBeAg-positive chronic hepatitis B. N Engl J Med. 354(10):1001-1010, 2006. https://doi.org/10.1056/NEJMoa051285
  4. Tenney, D.J., Rose, R.E., Baldick, C.J., et al. Long-term monitoring shows hepatitis B virus resistance to entecavir in nucleoside-naive patients is rare through 5 years of therapy. Hepatology. 49(5):1503-1514, 2009. https://doi.org/10.1002/hep.22841
  5. Zhang, L., Wang, G., Hou, W., Li, P., Dulin, A., Bonkovsky, H.L. Contemporary clinical research of traditional Chinese medicines for chronic hepatitis B in China: an analytical review. Hepatology. 51(2):690-698, 2010. https://doi.org/10.1002/hep.23384
  6. 채우석. 동씨기혈집성. 서울, 일중사, pp 251-255, 1997.
  7. 전국 한의과대학 간계내과학교수 공저. 간계내과학 4판. 서울, 동양의학연구원, pp 256-290, 2001.
  8. European Association For The Study Of The Liver. EASL Clinical Practice Guidelines: management of chronic hepatitis B. J Hepatol. 50(2):227-242, 2009. https://doi.org/10.1016/j.jhep.2008.10.001
  9. Dienstag, J.L., Schiff, E.R., Wright, T.L., et al. Lamivudine as initial treatment for chronic hepatitis B in the United States. New Engl J Med. 341(17):1256-1263, 1999. https://doi.org/10.1056/NEJM199910213411702
  10. Lai, C., Chien, R., Leung, N., et al. A one-year trial of lamivudine for chronic hepatitis B. Asia Hepatitis Lamivudine Study Group. N Engl J Med. 339(2):61-68, 1998. https://doi.org/10.1056/NEJM199807093390201
  11. Schalm, S.W., Heathcote, J., Cianciara, J., et al. Lamivudine and alpha interferon combination treatment of patients with chronic hepatitis B infection: a randomised trial. Gut. 46(4):562-568, 2000. https://doi.org/10.1136/gut.46.4.562
  12. Chang, T.T., Lai, C.L., Chien, R.N., et al. Four years of lamivudine treatment in Chinese patients with chronic hepatitis B. J Gastroenterol Hepatol. 19(11):1276-1282, 2004. https://doi.org/10.1111/j.1440-1746.2004.03428.x
  13. Lok, A.S., Lai, C.L., Leung, N., et al. Long-term safety of lamivudine treatment in patients with chronic hepatitis B. Gastroenterology. 125(6):1714-1722, 2003. https://doi.org/10.1053/j.gastro.2003.09.033
  14. Hadziyannis, S., Tassopoulos, N., Heathcote, E., et al. Long-term Therapy With Adefovir Dipivoxil for HBeAg-Negative Chronic Hepatitis B for up to 5 Years. Gastroenterology. 131(6):1743-1751, 2006. https://doi.org/10.1053/j.gastro.2006.09.020
  15. Marcellin, P., Heathcote, E.J., Buti, M., et al. Tenofovir disoproxil fumarate versus adefovir dipivoxil for chronic hepatitis B. N Engl J Med. 359(23):2442-2455, 2008. https://doi.org/10.1056/NEJMoa0802878
  16. Chang, T.T., Gish, R.G., de Man, R., et al. A comparison of entecavir and lamivudine for HBeAg-positive chronic hepatitis B. N Engl J Med. 354(10):1001-1010, 2006. https://doi.org/10.1056/NEJMoa051285
  17. Lai, C.L., Shouval, D., Lok, A.S., et al. Entecavir versus lamivudine for patients with HBeAg-negative chronic hepatitis B. N Engl J Med. 354(10):1011-1020, 2006. https://doi.org/10.1056/NEJMoa051287
  18. Sherman, M., Martin, P., Lee, W., et al. Entecavir results in continued virologic and biochemical improvement and HBeAg seroconversion through 96 weeks of treatment in lamivudine-refractory, HBeAg(+) chronic hepatitis B patients (ETV-026). Gastroenterology. 130(Suppl 2):A765, 2006.
  19. Tenney, D.J., Rose, R.E., Baldick, C.J., et al. Long-term monitoring shows hepatitis B virus resistance to entecavir in nucleoside-naive patients is rare through 5 years of therapy. Hepatology 49(5):1503-1514, 2009. https://doi.org/10.1002/hep.22841
  20. Lai, C.L., Gane, E., Liaw, Y.F., et al. Telbivudine versus lamivudine in patients with chronic hepatitis B. N Engl J Med. 357(25):2576-2588, 2007. https://doi.org/10.1056/NEJMoa066422
  21. Lim, S.G., Ng, T.M., Kung, N., et al. A double-blind placebo-controlled study of emtricitabine in chronic hepatitis B. Arch Intern Med. 166(1):49-56, 2006. https://doi.org/10.1001/archinte.166.1.49
  22. Yoo, B.C., Kim, J.H., Chung, Y.H., et al. Twenty-four-week clevudine therapy showed potent and sustained antiviral activity in HBeAg-positive chronic hepatitis B. Hepatology. 45(5):1172-1178, 2007. https://doi.org/10.1002/hep.21629
  23. Ferrucci, L.M., Bell, B.P., Dhotre, K.B., Manos, M.M., Terrault, N.A., Zaman, A., Murphy, R.C., Vanness, G.R., Thomas, A.R., Bialek, S.R., Desai, M.M., Sofair, A.N. Complementary and alternative medicine use in chronic liver disease patients. J Clin Gastroenterol. 44(2):e40-45, 2010. https://doi.org/10.1097/MCG.0b013e3181b766ed