Efficacy Of Interferon α-2b And Adefovir Dipivoxil Combin Therapy On Chronic Hepatitis B

Background:Chronic hepatitis B virus(HBV)infection is a global health problem and carries a risk of serious and even life-threatening complications. There are about 20 million people who have been infected with HBV worldwidely, of Which more than 350 million people are chronically infected HBV infection accounts for annually 1 million deaths worldwide, resulting from cirrhosis, liver failure and Heaptocellular carcinoma(HCC).China is a highly endemic area of HBV infection,in which HBsAg-positive rate of the population aged from 1 to 59 years was 7.18%. Chronic HBV infection seriously endangers the health of Chinese.Objective:To compare the clinical efficacy of interferon a-2b or adefovir dipivoxil(ADV) monotherapy and their combination therapy in HBeAg positive chronic hepatitis B (CHB) patients.Methods:An open randomized controlled clinical trial was performed. Ninety cases with CHB were divided into 3 group:interferon a-2b monotherapy (group A), ADV monotherapy (group B) and interferonα-2b plus ADV combination therapy (group C). The virological response, serlolgical response (HBeAg clearance and seroconversion), biochemical response and sustained response were tested at week 12 and 24 and 48of therapy for evaluation of theraprutic effects,safety. The efficacy was compared using x2 test.Result:At week 12,rate of aminotransferases normalization (group A 26.7%,group B 36.7%,group C 46.7%) HBeAg seroconversion rates (group A 23.3%,group B 6.7%,group C 26.7%) HBVDNA negative rate (group A 53.3%,group B 43.3%,group C 26.7%).There were not statistically significant among three groups(p>0.05).At week 24,rate of aminotransferases normalization (group A 30%,group B 36.7%,group C 66.7%) HBeAg seroconversion rates (group A 33.3%,group B 13.3%,group C 60%) HBVDNA negative rate (group A 43.3%,group B 56.7%,group C 83.3%).There were statistically significant among three groups(p<0.05). At week 48,rate of aminotransferases normalization (group A 66.7%,group B 73.3%,group C 93.3%) HBeAg seroconversion rates (group A 40%,group B 16.7%,group C 70%) HBVDNA negative rate (group A 53.5%,group B 63.3%,group C 93.3%). The patients in combination therapy group had significantly higher ALT normalization rate, HBeAg seroconversion rates and HBVDNA neative rate than those in monotherapy groups. There were t statistically significant among three groups(p<0.05).Conclusion:The virological response at week 24 and 48 of Interferon a-2b plus ADV combination therapy are better than Interferon a-2b or ADV monotherapy.