Clinical Observation of Lamivudine in Combination with Adefovir Dipivoxil in the Treatment of Decompensated Cirrhotic Patient with HBV for 96 Weeks

Objective To observe the curative efficacy,YMDD mutation and safety of lamivudine combined with adefovir dipivoxil treated Hepatitis B patients with decompensated cirrhosis.Methods 61 patients from our hospital between March 2006 and June 2009,were randomLy divided into two groups.28 patients in group A were treated with lamivudine 100mg per day.And 33 patients in group B were treated with lamivudine 100mg and adefovir dipivoxil 10mg per day.They also received living-protecting,and the other symptomatic treatments.The total treatment in these two groups was 96 weeks.The level of HBV DNA,Child-Pugh score,YMDD mutation and adverse drug reactions were detected detailedly.Results After the treatment,there were obvious undetectable rate of HBV DNA and improved Child Pugh score in the two groups.But the comparisons have no statistical difference(P0.05).YMDD mutation would appear at 48 weeks in group A which used lamivudine 100mg per day for treatment.The greater variation would come out as the time become longer.There were no YMDD mutation in group B at the total treatment.YMDD variation had significant differences between the two groups at 72 weeks(P0.05).Two groups have two example deaths respectively,and no medicine related serious untoward effect occured.Conclusion Using lamivudine combined with adefovir dipivoxi therapy or lamivudine monotherapy to treat Hepatitis B patients with decompensate cirrhosis,the curative efficacy and safety are similar,but the combination therapy treatment can significantly reduce the incidence of YMDD mutation.Combination therapy is an effective and ideal treatment of hepatitis B decompensated cirrhosis.