Clinical investigation of entecavir combined with adefovir dipivoxil in the treatment of adefovir-resistant hepatitis B cirrhosis / 中国基层医药

ABSTRACT

Objective To investigate the clinical effect of entecavir(ETV) combined with adefovir dipivoxil (ADV) in the treatment of adefovir-resistant hepatitis B cirrhosis.Methods 125 cases of liver cirrhosis with adefovir-resistantce were selected,they were divided into two groups.The treatment group included 67 cases who received the combined therapy with ETV and ADV.The control group included 58 cases who were treated with ETV.The ALT negative rate,HBV-DNA negative rate,HBeAg conversion rate,liver function Child-pugh score conversion rates were compared between the two groups within 12,24,48 weeks.Results After treatment for 12,24,48 weeks,in the treatment group,the ALT negative rates were 65.5％,81.0％,96.6％,respectively,the HBV-DNA negative rates were 62.0％,69.0％,77.6％,respectively,the HBeAg conversion rates were 0.0％,0.0％,17.2％,respectively.The ALT negative rate and HBV-DNA negative rate of the treatment group were higher than those in the control group within 12 and 24 weeks,the differences were statistically significant(ALT negative rate after 12 and 24 weeks,x2 =14.64,8.23;HBV-DNA negative rate after 12 and 24 weeks,x2 =4.57,14.24).The HBeAg conversion rate had no statistically significant difference between the two groups at any time.After treatment for 48 weeks,the Child-pugh score of the treatment group was (6.05 ± 2.11)points,which was significantly lower than (7.67 ± 1.12)points of the control group (t =1.89,P ＜ 0.05).The incidence rate of adverse reactions between the two groups had no statistically significant difference (P ＞ 0.05).Conclusion Entecavir combined with adefovir dipivoxil in the treatment of patients with hepatitis B cirrhosis has good effect on the ALT negative rate,HBV-DNA negative rate.It is worthy of clinical application.