Treatment of chronic hepatitis B with Adefovir dipivoxil:A 3 years observation of clinical efficacy and drug resistance

Objective To investigate the effect and drug resistance patterns of Adefovir dipivoxil in the treatment of chronic hepatitis B(CHB).Methods CHB patients were divided in to HBeAg positive(n=108) and HBeAg negative(n=55) groups.The liver function tests,HBVDNA and HBVM were analyzed during the treatment.The virus resistance mutation gene and nucleic acid amplification were performed by fluorescence quantitative sequencing in ineffective patients or patients with HBVDNA rebound ≥1 log10copies/ml.Results HBVDNA negativity reached its peak at the 48th week of treatment in HBeAg positive and HBeAb negative groups with a rate of 70.7% and 77.7% ,respectively.HBeAg negativity and anti-HBe seroconversion rates were 37.5% and 25.0% ,respectively in HBeAg-positive group and the rate was increased year by year.The HBVDNA negativity decreased at 144th week in both groups and the decrease in HBVDNA negativity in HBeAg negative group(40.0% ) was more than the HBeAg-positive group(9.4% )(P 0.01).24 weeks after cessation of treatment,12 and 4 patients with or without standard treatment,respectively were showed recurrence.From the total of 19 patients with liver cirrhosis,seven patients(36.8% ) developed liver cancer and chronic liver failure within 48 weeks of treatment.71.4% of HBeAg-negative cirrhosis patients with HBVDNA≥105copies/ml before treatment had poor prognosis.During the treatment,7 cases were shown rebound in which HBVDNA rebound was≥102copies/ml in two of the cases and 96W mutations were found in one patient.Two cases of rtA181IV and rtN236T mutations were found of which one had a short-term drug history.Another two cases of rtL180M and rtM204I/rtT184A mutations were found with a previous history of treatment with LAM,LdT and ETV.Conclusion Dipivoxil for the treatment of the Arab-Israeli group HBVDNA negative response rate up to the summit in the 48th week,HBeAg negative and positive 3 years showed an upward trend year after year.The end of the standard drug treatment and not following the end standard drug treatment time for a similar rebound in viral genes.Anti-Hbe positive cases of liver cirrhosis HBVDNA≥105copies/ml deterioration 1 year after treatment the proportion of large.HBVDNA increased to ≥1log10copies/ml as clinical indicators in line with the virus rebound is not high.