Observation of combination therapies with lamivudine and adefovir dipivoxil at different times for chronic hepatitis B

Abstract

Objective To compare the efficacy of combination therapy with lamivudine(LAM) and adefovir dipivoxil(ADV) for LAM-poorly responsed and LAM-resistant to those de novo combination therapy for chronic hepatitis B (CHB).Methods Twenty CHB patients with poorly response to LAM were selected as group A,20 LAM-resistant patients as group B,other 20 CHB patients received combination therapy for the first time as group C.All the patients were given LAM ( 100 mg/d) and ADV (10 mg/d) for 48 weeks,the level of HBV DNA,ALT and HBeAg in patients were detected and HBV mutation was detected for whose HBV DNA were still positive after treatment.Results The negative rate of HBV DNA in group A,B and C were 85％,80％,90％ ( F =0.784,P ＞ 0.05),and the negative rate of HBeAg were 31.3 ％,30.8 ％,33.3 ％ ( F =0.025,P ＞ 0.05) in group A,B,C,respectively.The level of HBV DNA and ALT decreased remarkably after 48 combination treatment in group A,B,C ( t =9.706,10.871,11.807,P ＜ 0.01 ;t =2.157,2.109,2.653,P ＜ 0.05).HBV DNA in 9 patients were still positive after treatment,but no HBV mutations were detected in three groups.Concusions The combination therapy of LAM and ADV can effectively inhibit HBV replication,improve ALT level in CHB patients,but the efficacy in HBeAg seroconversion rate are not obvious.The efficacy of combination therapy in three groups are similar.No HBV mutations are detected for three groups. Key words: Hepatitis B,chronic; Lamivudine; Adefovir dipivoxil; Combination therapy