Effect of Chinese medicine therapy for strengthening-Pi and nourishing-Shen in preventing lamivudine induced YMDD mutation and its immunologic mechanism.
OBJECTIVE
To observe the effect of Chinese medicine therapy for strengthening-Pi and nourishing-Shen (SPNS) in preventing lamivudine induced YMDD mutation and its immunological mechanism.


METHODS
One hundred and sixty chronic hepatitis B (CHB) patients with positive HBeAg were equally assigned to two groups at random: the observation group and the control group. Patients in the observation group were treated with lamivudine combined with SPNS, and those in the control group were treated with lamivudine only, with the treatment lasting for 52 weeks in total. Changes in indexes, including liver function, HbeAg, HBV-DNA, YMDD variation, CD(4), CD(4)/CD(8) ratio, interferon-gamma (IFN-gamma), interleukin-4 (IL-4), blood routine, renal function, as well as any adverse reactions that occurred in patients, were observed at different time points.


RESULTS
The ALT, AST recovery rate and HBV-DNA negatively inversing rate at the 24th week, the 36th week and the 52nd week were all higher (P<0.05); meanwhile, the YMDD mutation rate at the 36th week and the 52nd week was lower (P<0.05) in the observation group than in the control group. The posttreatment levels of CD(4), CD(4)/CD(8) ratio, IFN-gamma, and IL-4 as well as the pre-post treatment difference of these indexes in the observation group were significantly different from those in the control group (P<0.05).


CONCLUSIONS
Chinese medicine SPNS therapy can significantly reduce the YMDD variation of HBV, and the mechanism may be related to its regulation of the CD(4) level, CD(4)/CD(8) ratio and Th1/Th2 balance.
Feng
Hui
H
Department of Hepatopathy, Zhejiang Provincial Hospital of Integrative Medicine, Hangzhou 310004, China.
Zhang
Yong-hua
YH
D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D004279:DNA, Viral / Q000235:genetics; D024882:Drug Resistance, Viral / Q000187:drug effects* / Q000235:genetics / Q000276:immunology; D005260:Female; D005814:Genes, Viral; D006515:Hepatitis B virus / Q000235:genetics* / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000276:immunology / Q000517:prevention & control / Q000821:virology; D006801:Humans; D057131:Immune Evasion / Q000235:genetics*; D019259:Lamivudine / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008516:Medicine, Chinese Traditional / Q000379:methods*; D008875:Middle Aged; D009154:Mutation / Q000502:physiology; D010166:Palliative Care / Q000379:methods*; D055502:Secondary Prevention; D055815:Young Adult
D000998:Antiviral Agents; D004279:DNA, Viral; D019259:Lamivudine