Adefovir dipivoxil in treatment of decompensated liver cirrhosis patients with YMDD mutation

Objective To evaluate the clinical benefits and safety of adefovir therapy in patients with decompensated liver cirrhosis resulting from hepatitis B YMDD mutants during the course of treatment of lamivudine.Methods 28 patients with decompensated liver cirrhosis with YMDD mutation were randomly divided into two groups:15 patients in the treatment group and 13 in the control.The patients in both groups received routine therapy and continued to receive lamivudine at a dose of 100mg daily,however the patients in treatment group received adefovir at a dose of 10mg daily,and the course of treatment was 1 year.Results In the control group,1 case died of hepatoma and liver function failure,2 died of upper gastrointestinal bleeding;and in the treatment group,1 case was out off the regimen because of the light increase of serum creatinine after 1 week of treatment.After 1 year of treatment,the rate of the liver function recovery and the rate of HBV DNA negativity in the treatment group were higher than that in the control group(P0.01).And the case fatality was 0% in treatment group,while 23.08 % in the control group.Conclusions Adefovir is effective and safe for patients with decompensated liver cirrhosis with YMDD mutation,and adefovir can improve the prognosis of the patients.