Comparison of efficacy between two treatment strategies in lamivudine-refractory patients with chronic hepatitis B:lamivudine plus adefovir dipivoxil versus entecavir

Objective To evaluate the efficacy between lamivudine plus adefovir dipivoxil and entecavir mono-therapy in lamivudine-refractory patients with chronic hepatitis B.Methods Chinese and English articles published in PUBMED,EMBASE,CNKI before July 2010 about comparison of efficacy between lamivudine plus adefovir dipivoxil and entecavir mono-therapy in lamivudine-refractory patients with chronic hepatitis B were searched.The dosages of lamivudine,adefovir dipivoxil and entecavir were respectively 100 mg/d,10mg/d and 1mg/d,and continuing time all last over 48 weeks.Heterogeneity was examined by Chi-square(χ2) test,the relative risk was calculated and forest-plot was drawn.The evaluated index contained the rates of undetected serum HBV DNA,serum ALT normalization,and HBeAg seroconversion.Results There were no statistic significances on the rates of undetected serum HBV DNA(P=0.25),serum ALT normalization(P=0.61),and HBeAg seroconversion(P=0.33) at week 48 between the lamivudine plus adefovir dipivoxil group and the entecavir mono-therapy group.Conclusion Efficacy between lamivudine plus adefovir dipivoxil and entecavir mono-therapy for lamivudine-refractory patients with chronic hepatitis B was similar.