RESUMEN
OBJECTIVE: To compare the efficacy of lamivudine (LAM) combined with adefovir dipivoxil (ADV) de novo and entecavir(LTV) monotherapy in treatment of patients with hepatitis B virus (HBV)-related decompensated cirrhosis for one year. METHODS: Sixty HBV-infected patients with decompensated cirrhosis treated with LAM combined with ADV de novo and 40 patients treated with ETV were enrolled. Liver and kidney function, HBVDNA, HBVM, AFP, US or CT scan of liver were tested every 1-3 month. The treatment efficacy was evaluated at month 12. RESULTS: By month 12, the HBV DNA negative rates in LAM combined with ADV de novo group (45 cases) and ETV monotherapy group (30 cases) were 51.1% and 60.0% respectively. There was no significant difference(P>0.05). The HBeAg negative rates in LAM + ADV group and ETV group were 30.4% and 26.7% respectively. There was no significant difference (P>0.05). The ALT normalization rates in two groups were similar. Viral breakthrough happened in 2 cases (4.4%) by month 12 in LAM + ADV group, and no viral resistance was observed, while viral breakthrough happened in 1 case (3.3%) by month 12 in ETV group. Improvement of liver function was obvious in both groups, for CTP and MELD scores decreased distinctly. The accumulative total mortality or liver transplantation rates were 9.4% and 8.7% respectively in LAM + ADV group and ETV group. No increase in blood creatinine above the upper normal limit was observed in both groups. CONCLUSION: Both of LAM combined with ADV de novo and ETV monotherapy are best choice in treatment of patients with HBV-related decompensated cirrhosis. They can inhibit HBV replication obviously, improve liver function and decrease mortality.