A comparison of Entecavir and Lamivudine for subacute-on-chronic liver failure infected with HBV.

Objective To compare the effects of Entecavir and Lamivudine on patients with subacute-on-chronic liver failure infected with hepatitis B virus (HBV). Methods 93 patients with no prior history of antiviral therapy were divided randomly into two groups:Entecavir group (46 cases), and Lamivudine group (47 cases). The dosage in the Entecavir group and Lamivudine group was 0.5 mg / d and 100 mg / d, respectively, and the duration of therapy was 48 weeks. The effects of Entecavir and Lamivudin on TBiL, ALT, ALB, PTA, HBV DNA, survival rate and virologic rebound were observed during the treatment. Results The ALT levels in Entecavir group were significantly higher than the Lamivudine group at 4 and 12 weeks, and the other indexs had no significant difference. The HBV DNA negative conversion rate in the Entecavir group was higher than that in Lamivudine group,which was 71.7% versus 51.1% on week 4, and 97.8% versus 72.3% on week 48 after treatment. The survival rate in Entecavir group (80.4%) was higher than that in Lamivudine group (61.7% ). No viral resistance was observed in Entecavir group, but 5 patients in Lamivudine group had virological rebound during 48 weeks. Conclusion Entecavir is more effective in inhibiting reproduction of HBV than that of Lamivudine,and there is no evidence of viral resistance to entecavir. So Entecavir could be used for long-term treatment of the patients with subacute on chronic liver failure.