De novo combination therapy with lamivudine and adefovir dipivoxil versus entecavir monotherapy for na(i)ve chronic hepatitis B patients with high viral loads

( views:226, downloads:0 )
Author:
ZHANG Jian-chun(Department of Infectious Diseases,Jiangyin People's Hospital,Jiangyin 214400,Jiangsu Province,China)
Journal Title:
Chinese Journal of Clinical Infectious Diseases
Issue:
Volume 05, Issue 03, 2012
DOI:
10.3760/cma.j.issn.1674-2397.2012.03.004
Key Word:
Chronic Hepatitis B;Lamivudine;Adefovir dipivoxil;Entecavir;Drug resistance

Abstract: Objective To evaluate the efficacy,drug resistance and safety of combination therapy with lamivudine (LAM) and adefovir dipivoxil (ADV) or entecavir (ETV) monotherapy for chronic hepatitis B (CHB) patients with high viral loads (HBV DNA ≥ 107copies/mL).Methods Seventy CHB patients with high viral loads were collected from Jiangyin People' s Hospital in Jiangsu Province during May 2007 and January 2009.All patients were randomized into combination therapy group and monotherapy group.Combination therapy group was treated with lamivudine ( 100 mg/d) and adefovir dipivoxil ( 10 mg/d) for 96 weeks,and monotherapy group was treated with entecavir (0.5 mg/d) for 96 weeks.x2 test was used to compare the ALT normalization rates,HBV DNA negative rates and HBeAg sernconversion rates between two groups.Results After 96 weeks' treatment,the ALT normalization rate,HBV DNA negative rate and HBeAg seroconversion rate of combination therapy group were 97.1% (34/35),94.3% ( 33/35 )and 48.6% ( 17/35 ),respectively ; those of monotherapy group were 77.1% ( 27/35 ),77.1% ( 27/35 )and 17.1 % (27/35),respectively ; the differences were of statistical significance (x2 =6.248,4.200 and 7.835,P <0.05 or P <0.01 ).There was no virological breakthrough in combination therapy group during 96 weeks' treatment,but it was found that 2 patients had virological breakthrough in monotherapy group and they were ETV-resistant.No severe adverse reaction was found in both groups.Conclusion LAM + ADV combination therapy is better in viral suppression,and has lower resistance and higher HBeAg seroconversion rate than ETV monotherapy for CHB patients with high viral load.

  • [1]核苷(酸)类药物联合治疗慢性乙型肝炎专家建议.中华临床感染病杂志,2011,4(2):65-68.
  • [2]Liaw YF,Leung N,Kao JH,et al.Asian-pacific consensus statement on the management of chronic hepatitis B:a 2008 update.Hepatol Int,2008,2(3):263-283.
  • [3]王世其.拉米夫定联合阿德福韦与恩替卡韦单药对慢性乙型肝炎初治患者的疗效比较.山东医药,2011,51(20):100-101.
  • [4]中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2010年版).中华临床感染病杂志,2011,4(1):1-13.
  • [5]喻剑华,施军平,武静,等.拉米夫定和阿德福韦酯初始联合与恩替卡韦单药治疗慢性乙型肝炎的疗效和安全性对比.中华肝脏病杂志,2011,19(2):88-92.
  • [6]施军平.慢性乙型肝炎的抗病毒治疗:初始联合还是优化治疗?.国际肝病,2012,1:6-7.
  • [7]贾红宇,卢微,郑临,等.拉米夫定单药及其初始联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化的疗效比较.中华肝脏病杂志,2011,19(2):84-87.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn