De novo combination therapy with lamivudine and adefovir dipivoxil versus entecavir monotherapy for na(i)ve chronic hepatitis B patients with high viral loads
10.3760/cma.j.issn.1674-2397.2012.03.004
- VernacularTitle:拉米夫定和阿德福韦酯初始联合与恩替卡韦单药治疗高病毒载量慢性乙型肝炎疗效观察
- Author:
Jianchun ZHANG
- Publication Type:Journal Article
- Keywords:
Chronic Hepatitis B;
Lamivudine;
Adefovir dipivoxil;
Entecavir;
Drug resistance
- From:
Chinese Journal of Clinical Infectious Diseases
2012;05(3):142-144
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy,drug resistance and safety of combination therapy with lamivudine (LAM) and adefovir dipivoxil (ADV) or entecavir (ETV) monotherapy for chronic hepatitis B (CHB) patients with high viral loads (HBV DNA ≥ 107copies/mL).Methods Seventy CHB patients with high viral loads were collected from Jiangyin People' s Hospital in Jiangsu Province during May 2007 and January 2009.All patients were randomized into combination therapy group and monotherapy group.Combination therapy group was treated with lamivudine ( 100 mg/d) and adefovir dipivoxil ( 10 mg/d) for 96 weeks,and monotherapy group was treated with entecavir (0.5 mg/d) for 96 weeks.x2 test was used to compare the ALT normalization rates,HBV DNA negative rates and HBeAg sernconversion rates between two groups.Results After 96 weeks' treatment,the ALT normalization rate,HBV DNA negative rate and HBeAg seroconversion rate of combination therapy group were 97.1％ (34/35),94.3％ ( 33/35 )and 48.6％ ( 17/35 ),respectively ; those of monotherapy group were 77.1％ ( 27/35 ),77.1％ ( 27/35 )and 17.1 ％ (27/35),respectively ; the differences were of statistical significance (x2 =6.248,4.200 and 7.835,P ＜0.05 or P ＜0.01 ).There was no virological breakthrough in combination therapy group during 96 weeks' treatment,but it was found that 2 patients had virological breakthrough in monotherapy group and they were ETV-resistant.No severe adverse reaction was found in both groups.Conclusion LAM + ADV combination therapy is better in viral suppression,and has lower resistance and higher HBeAg seroconversion rate than ETV monotherapy for CHB patients with high viral load.
