Predictors of response in patients with HBeAg-positive chronic hepatitis B with adefovir dipivoxil treatment / 中国实用内科杂志

ABSTRACT

Objective To investigate the effective predictors of response in HBeAg-positive patients treated with adefovir dipivoxil(ADV)and to provide evidence for individualized treatment.Methods Patients administered with ADV for 48 weeks in a randomized,placebo-controlled,multicenter trial were studied.Statistical analyses,such as Backward stepwise logistic regression and 2?2 method were used for predictors analysis at week 48.Results The baseline serum ALT levels,HBV DNA levels,and undetectable serum HBV DNA by PCR at week 24 were predictors for HBV DNA negativity at week 48.The median of serum ALT levels and HBV DNA levels prior to treatment were 134.5 U/L and 6.57 lg copies/mL,respectively.Patients with baseline ALT levels higher than the median,HBV DNA levels lower than the median,and serum HBV DNA undectectable by PCR at week 24 had greater rate of HBV DNA negativity(93.3%),HBeAg loss(60%)and HBeAg seroconversion(40%)at week 48 than the others.47.8% of patients whose HBV DNA levels were positive at week 24 also achieved HBV DNA negativity at week 48,and 8.6% achieved HBeAg seroconversion.Conclusion Better response at week 48 has significantly higher serum ALT levels and lower HBV DNA levels prior to treatment and HBV DNA negativity at week 24 compared with non-response.Patients whose HBV DNA levels ware still positive at week 24 should continue therapy.