Comparison of efficacy between entecavir and adefovir dipivoxil in lamivudine-refractory patients with chronic hepatitis B

Objective To evaluate the efficacy of entecavir and adefovir dipivoxil in lamivudine-refractory patients with chronic hepatitis B.Methods Both Chinese and English articles published before June 2010 about the efficacy of entecavir and adefovir dipivoxil in lamivudine-refractory patients with chronic hepatitis B were searched and analyzed.The dosages of entecavir and adefovir dipivoxil used in the patients for over 48 weeks were 1 mg/d and 10 mg/d,respectively.Heterogeneity was examined by Chi-square test,the relative risk was calculated and forest-plot was drawn.The evaluation index was the rate of undetected serum HBV DNA.Results from meta-analysis showed that the rate of undetected serum HBV DNA at week 48 in the group with adefovir dipivoxil treatment was lower than the group receiving entecavir(Z=2.26,P=0.02),and the confidence interval of relative risk was 0.51～0.95.Conclusion Entecavir was found to be superior to adefovir dipivoxil in decreasing serum HBV DNA in lamivudine-refractory patients with chronic hepatitis B.