Zhang Q, Zhang L, Xing Y, Qin Y, Liu G
Department of Gastroenterology, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province, Cangzhou, 061000, China.
Acta Gastroenterol Belg. 2019 Jan-Mar;82(1):31-34.
To compare the efficacy of treatment with lamivudine (LAM) plus adefovir (ADV) or entecavir (ETV) monotherapy in LAM treatment failure patients with HBeAg negative chronic hepatitis B (CHB) patients during 48 weeks of therapy.
Thirty patients with HBeAg negative CHB were enrolled in the study. The serum levels of HBV DNA, HBsAg/HBsAb, and ALT were assessed by enzyme-linked immunosorbent assay at 0, 12, 24, 36, and 48 weeks.
The rate of undetectable HBV DNA in the LAM+ADV group was 100%, which was higher than the ETV group at 48 weeks (73.33%, χ2 = 4.615, P = 0.032). Multivariate analysis using the Cox proportional hazards model showed that therapy with LAM+ADV or baseline levels of HBV DNA <107 copies/ml were independent predictive factors for undetectable HBV DNA rates in all patients (RR: 2.488, P = 0.042; RR: 0.201, P = 0.035).
During the 48 weeks of treatment in patients with HBeAg negative CHB, LAM plus ADV suppressed HBV replication more effectively than ETV monotherapy. In addition, no virologic breakthrough was detected in the LAM add-on ADV group. Additionally, therapy with LAM+ADV or baseline levels of HBV DNA <107copies/ml were independent predictive factors for undetectable HBV DNA rates in patients.
比较拉米夫定（LAM）联合阿德福韦（ADV）与恩替卡韦（ETV）单药治疗拉米夫定治疗失败的HBeAg阴性慢性乙型肝炎（CHB）患者48周的疗效。
30例HBeAg阴性CHB患者纳入研究。在第0、12、24、36和48周通过酶联免疫吸附测定法评估血清HBV DNA、HBsAg/HBsAb和ALT水平。
LAM+ADV组HBV DNA不可检测率为100%，高于ETV组48周时的73.33%（χ2 = 4.615，P = 0.032）。使用Cox比例风险模型进行多因素分析显示，LAM+ADV治疗或基线HBV DNA水平<107拷贝/ml是所有患者HBV DNA不可检测率的独立预测因素（RR：2.488，P = 0.042；RR：0.201，P = 0.035）。
在HBeAg阴性CHB患者48周治疗期间，LAM联合ADV比ETV单药治疗更有效地抑制HBV复制。此外，LAM联合ADV组未检测到病毒学突破。此外，LAM+ADV治疗或基线HBV DNA水平<107拷贝/ml是患者HBV DNA不可检测率的独立预测因素。
