Clinical efficacy of adefovir dipivoxil in treatment of lamivudine resistance in decompensated liver cirrhosis patients with hepatitis B

Objective To evaluate the clinical benefits and safety of adefovir dipivoxil therapy in patients with decompensated liver cirrhosis resulting from hepatitis B and YMDD mutants during the treatment of lamivudine.Methods Sixty patients with decompensated liver cirrhosis with YMDD mutation during the treatment of lamivudine were randomly divided into two groups;30 patients in the treatment group and 30 patients in the control group.The patients in both groups received routine therapy and continued to receive lamivudine at a dose of 100 mg daily,moreover,the patients in treatment group received adefovir dipivoxil at a dose of 10 mg daliy and the treatment course was 15 months.Results In the control group,1 cases died of hepatoma,3 cases died of upper gastrointestinal bleeding,1 case died of lung fungus infection and liver function failure,1 case died of abdomen infection and liver function failure.After 15 months of treatment,the rate of liver function recovery and 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 23.3% in the control group.Conclusions Adefovir dipivoxil is effective and safe for patients with decompensated liver cirrhosis and YMDD mutation and can improve patients' prognosis and the quality of life.