Clinical Study On Therapeutic Effect Of Interferon Combined Lamivudine On HBV Of Chronic Hepatitis B

[Objective]To evaluate the therapeutic efficacy of interferon combinated lamivudine and interferon or lamivudine monotherapy in patients with chronic hepatitis B [Methods] 142 patients with chronic hepatitis B wliose HbeAg HBV-DNA were positive were chosen according to the standard criterion and randomly divided into 4 groups:35 patients were treated with interferon for 4 months (A group) ,38 patients were treated with lamivudine at least 1 year(B group), 29 patients were treated with interferon combinated lamivudine in the same ways(C group),40 patients were treated with Ganlixin and ChuiPengChao as control(D group). We tested the response rates of serum HBV-DNA and HBeAg. the ALT normalization rate the growth of CD4+/ CD? in peripheral blood of every group after 1 year. We observed the histological improvement of the liver before and after therapy and the adverse events. [Results] The response rate of serum HBeAg of A group B group C group and D group were 20.00% 15.79% 34.48%and2.50% respectively,it was significantly greater of A group and C group than of D group respectively.The response rate of serum HBV-DNA of those four groups were 37.14% 55.26% 65.52 %andO.OO% respectively,it was significantly greater of A group B group and C group than of D group respectively,and was significantly greater of B group and C group than of A group respectively.The ALT normalization rate of those four groups were 40.00 % 60.53 % 72.41% and 10.00%respectively, it was significantly greater of A group> B group and C group than of D group respectively, and was significantly greater of C group than of A group. The response rate of HBV-DNA was significantly greater to interferon combined lamivedine than to interferon monotherapy and the response rate of HBeAg is significantly greater to interferon combined lamivedine than to lamivudine monotherapy among patients with low level viremia (HBV-DNA<100pg/ml). The growth of CD4+/ CD8+ is significantly greater to interferon combinated lamivudine than to interferon or lamivudine monotherapy . Meanwhile,liver boipy was done in 1 patient before and after the treatment with interferon combinated lamivudine, which showed obvious histological improvement. Combination therapy has not increased the rate of adverse events [Conclution] The therapeutic effective rate to interferon combined lamivudine is greater than interferon or lamivudinemonotherapy ,especially when whose serum HBV-DNA level was lower than 100pg/ml.