Clinical study of optimization of treatment with lamivudine or de novo combination therapy with lamivudine and adefovir dipivoxil for chronic hepatitis B after 48 weeks / 中国医师杂志

ABSTRACT

Objective To investigate the clinical efficacy of the optimization of treatment with lamivudine or de novo combination therapy with lamivudine and adefovir dipivoxil.Methods A total of 98 cases of chronic hepatitis B patients were randomly divided into optimization of treatment group and de novo combination therapy group,optimization of treatment group treated with lamivudine optimization therapy,de novo combination therapy group treated with lamivudine and adefovir dipivoxil,virological,serological,biochemical and other indices were detected every 12 weeks,analyzed treatment effect after 48 weeks.Results Two groups were comparable baseline before treatment(P ＞0.05).HBV DNA negative rate,e antigen-negative rate,and resistance rates at week 48 were 86％,37％,and 0 in the de novo combination therapy group,and 59％,12％ and 18％ in the optimized treatment group (P ＜0.05).The e antigen seroconversion and ALT normalization rates were 23％ and 91％ in the de novo combination group,and 6％ and 86％ in the optimized treatment group (P ＞0.05).There was similar incidence of adverse reactions.Conclusions Compared to the de novo combination therapy group,the lamivudine-optimized treatment group can achieve higher HBV-DNA negative rate,e antigen-negative rate,lower resistance rates,and good safety.