De novo combination of lamivudine and adefovir versus entecavir monotherapy for the treatment of na?ve HBeAg-negative chronic hepatitis B patients

摘要

PurposeEither combination treatment or monotherapy using agents with a high genetic barrier are recommended for hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB). The aim of this study was to compare effect of na?ve HBeAg-negative CHB patients with either de novo combination of lamivudine (LAM) and adefovir dipivoxil (ADV) or entecavir (ETV) monotherapy.MethodsHBeAg-negative CHB patients (n?=?71) with ALT levels between 2 and 10 times the upper normal limit and HBV DNA levels >104?copies/mL were enrolled. Patients were treated with either LAM 100?mg plus ADV 10?mg per day (n?=?31) or ETV 0.5?mg per day (n?=?40) for 48?weeks.ResultsThe average reduction in HBV DNA level compared with baseline were 5.16?±?1.69 log in the LAM?+?ADV group and 5.36?±?1.70 log in the ETV group by week 48 (P?=?0.624). The virological response (VR) rates were 80.65 and 77.5%, the biochemical response (BR) rates were 93.55 and 90.00% at week 48 in the LAM?+?ADV and ETV groups, respectively. There was no significant difference in the VR and BR between the two groups. During the 48-week treatment period, virological breakthrough and serious side effects were not noted in any patient.ConclusionsBoth LAM?+?ADV combination therapy and ETV monotherapy are effective in na?ve HBeAg-negative CHB patients, but further studies are needed to obtain long-term results.