A Clinical Research Of Adefovir Dipivoxil For The Treatment Of Patients With Chronic Hepatitis B

Objective To evaluate the antiviral efficacy and safety of adefovir dipivoxil(ADV) on patients with chronic hepatitis B(CHB) by comparing with lamivudine(LAM).Method To divide 47 patients with CHB randomizely into two groups:ADV group and LAM group.The dosage in the ADV group was 10 mg/d and in the LAM group was 100 mg/d,the duration of therapy in the two groups were 52 weeks.During follow-up visit time,to collect blood serum of patients in two grougs and to observe HBV DNA levels,ALT levels,HBVM,et al.After 52 weeks,to detect the YMDD motif mutations in LAM group by using fluorimetric realtime PCR.Results After 52 weeks,the rates of clinical efficacy were 52.17%in ADV group and 69.57%in LAM group.(P＞0.05) ADV and LAM had the same antiviral efficacy,in two groups,the antiviral efficacy on patients with HBeAg negative were superior to patients with HBeAg positive(P＜0.05);At the early treatment,the HBV DNA negative conversion rates and the ALT recovery rates in LAM group were higher than in ADV group,but with the development of the treatment,these rates were similar;The rebound rates of ensemble and patients with HBeAg negative in LAM group were higher than in ADV group,but the rebound rates of patients with HBeAg positive in ADV group were higher than in LAM group.These were not statistical difference;(P＞0.05) The rates of side effects in ADV group and LAM group were 12.5% and 17.39%.These were not statistical difference.(P＞0.05) There were not serious dys-incidents in two groups;In 23 patients treated with lamivudine,we detected 3 patients with YMDD motif mutations,2 cases were YIDD and 1 case was YVDD,the total mutation rate was 13%.Among the 3 cases,2 cases were in high HBV DNA levels and ALT levels.Conclusion After 52 weeks,the antiviral efficacy and satety of ADV and LAM for the treatment of patients with chronic hepatitis B were similar;At the early treatment,the antiviral efficacy of LAM was superior to ADV,but with the development of the treatment,they were similar;After 52 weeks,patients treated with LAM were detected with YMDD motif mutations,the total mutation rate was 13%.