Efficacy Comparison Of Different Therapy Methods With Adefovir And/or Lamivudine In Chronic Hepatitis B

Objective To compare the single-use efficacy of adefovir dipivoxil and lamivudine plusadefovir dipivoxil poor in patients with chronic hepatitis B in anti-viral treatment, tounderstand whether the effects of lamivudine affect efficacy of adefovir dipivoxil.To investigate single-use efficacy of domestic and original adefovir on the anti-viraltreatments of the patients with chronic hepatitis B, and then compare therapeuticaldiscrepancy between two types of drug.Methods Using a retrospective analysis, the216cases of hepatitis B patients weredivided into three groups according to drug use. A group to lamivudine (100mg/d)treatment, B group to adefovir dipivoxil (10mg/d) treatment; C group thoroughly tolamivudine (100mg/d) treatment, plus adefovir dipivoxil (10mg/d) when the results arepoor. Blood treatment of12weeks,24weeks and48weeks respectively and detect theserum ALT, HBeAg, HBV DNA change.113cases of hepatitis B patients were reviewed retrospectively. These cases weredivided into two categories in term of drug-use: A group was treated using domesticadefovir dipivoxil (10mg/d); B group using original one (10mg/d). The efficacy was assessed by monitoring the serum ALT, HBeAg and HBV DNA change after12,24and48weeks of therapy.Results The treatment for12weeks,24weeks and48weeks in group A、group B andgroup C virologic response rates were62.5%、51.9%and59.5%,78.8%、63.0%and65.0%,86.3%、71.2%and88.9%, the P values were0.389、0.087and0.047;Biochemical response rates were43.8%、41.4%and44.9%,57.5%、53.4%and70.0%,70.0%、65.2%and77.8%, the P values were0.912、0.413、0.566; Eantigen-negative conversion rates were51.7%、38.9%and18.5%,56.7%、56.0%and43.8%,61.7%、70.8%and50.0%，the P values were0.014、0.637and0.364; E antigenseroconversion rates were45.0%、27.8%and14.8%，55.0%、40.0%and25.0%，56.7%、45.8%and33.3%, the P values were0.013、0.064and0.255.After12,24and48weeks of therapy, the virologic response rates of A and B groupwere48.2%and56.3%,56.8%and59.4%,63.0%and56.3%, and the P values were0.438,0.836and0.528, respectively; Biochemical response rates were40.7%and56.3%,46.9%and56.3%,61.7%and62.5%, and the P values were0.136,0.371and0.939, respectively; E antigen-negative conversion rates were16.4%and20.0%,24.6%and28.0%,34.4%and40.0%, and the P values were0.930,0.742and0.240,respectively; E antigen seroconversion rates were13.1%and16.0%,19.7%and24.0%,21.3%and44.0%, and the P values were0.994,0.654and0.033. The statistic resultsindicate only E antigen seroconversion showed significant statistical difference after48weeks of therapy.Conclusion For the initial treatment of the poor effect of lamivudine for chronichepatitis B patients, lamivudine plus adefovir does not affect late curative effect.For the initially treated patients, there is no significant difference of clinical curative effect between domestic and original of adefovir; however, with prolonged therapyperiod, original adefovir may show higher seroconversion rate than domestic one.