Objective To evaluate the efficacy of adefovir dipivoxil (ADV) on patients with chronic hepatitis B,and its association with HBV genotypes.Methods 75 patients with chronic hepatitis B were treated with ADV for 48 weeks-and the HBV genotypes were detected.ResultS In all patients-HBV genotype B;C and B/C were 49 (65.4%) , 22 (29.3%) and 4 (5.3%) ,respectively;ALT normalization and HBV DNA negative rates at week 48 were 58.7% and 50.7%, HBeAg loss and HBeAg seroconversion rates were 34.9% and 1.5% , respectively;The ALT normalization and HBV DNA negative rate in genotype B group at week 12 were 26.5% and 38.8% > which came to 55.1% and 53.1% at week 48; respectively; while in genotype C group at 12 week were 13.6% and 31.8%; which came to 59.1% and 36.4% at 48 week, respectively.ConluSionS The baseline HBV DNA levels affect the antiviral response to ADV, especially in patiens with HBV DNA＞l×l05copies/ml.There was no association between the efficacy of adefovir dipivoxil and HBV genotypes.%目的 观察阿德福韦酯初始治疗慢性乙型肝炎患者48周疗效及其与HBV基因型的关系.方法 75例慢性乙型肝炎患者接受国产阿德福韦酯治疗48周,观察治疗期间ALT、AST、HBV DNA、HBeAg等指标变化,并检测患者HBV基因型.结果在75例中检出B基因型49例(65.3%),C基因型22例(29.3%),B/C基因型4例(5.3%);治疗48周时ALT复常率和HBV DNA转阴率分别为58.7%和50.7%,HBeAg消失率为34.9%,HBeAg血清转换率为1.5%;在治疗12周时,B基因型组ALT复常率和HBV DNA阴转率分别为26.5%和38.8%,48周时为55.1%和53.1%,在治疗12周时,C基因组ALT复常率和HBV DNA阴转率为13.6%和31.8%,48周为59.1%和36.4%(P＞0.05).结论基线HBV DNA>1×105copies/ml的慢性乙型肝炎患者初始采用ADV治疗,HBeAg血清学转换率较低,ADV治疗的疗效与HBV基因型无关.
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