RESUMEN
Objective To compare the efficacy, tolerance and cost of interferon (IFN) α-2b and adefovir (ADV) in patients with chronic hepatitis B (CHB) for two years. Methods The treatmentnaive outpatients with CHB were treated with IFN α-2b or ADV according to intention to treat.Among 77 patients, 34 were treated with recombinant IFN α-2b 5 MU once every other day subcutaneously (IFN group), 43 were treated with ADV 10 mg/day orally (ADV group). The medications were stopped or the regimens were changed due to intolerant adverse reactions or without effects according to intention to treat. The patients were followed up for 24 months. The therapeutic effects, adverse reactions, compliance and cost of two initial treatments were compared. The data were analyzed by Fisher exact probability test. Results The complete virological response (HBV DNA＜500 copy/mL) rates after 12 months of therapy in IFN group and ADV group were 41.2% (14/34)and 67. 4 % (29/43), respectively, while the alanine aminotransferase (ALT) normalization rates were41.2% (14/34) and 93. 0% (40/43), respectively. The rates in ADV group were both significantly greater than those in IFN group (both P＜0.01). There were no statistically significant differences of HBeAg negative rate and HBeAg seroconversion rate between the two groups. In IFN group, the expulsion rate was 23. 5% (8/34), the therapy was discontinued in 8. 8% (3/34) of patients due to adverse reactions and the medication was changed in 47.1% (16/34) of patients. In ADV group, there were no adverse reactions associated with medication during 2-year therapy and patients were well tolerant, the expulsion rate was 7.0% (3/43) and the regimen in 9.3% (4/43) of patients was changed (P＜0.01). The comparison of therapeutic cost between the two groups showed that the cost of anti-viral therapy, management with adverse reactions and laboratory examinations in IFN group were all higher than those in ADV group. The average cost per person of two years was increased with RMB 4855 yuan in IFN group. Conclusion In HBeAg-positive CHB patients, ADV is cost-effective and suitable choice for initial antiviral treatment.