Clinic observation of adefovir dipivoxil in the treatment of lamivudine-resistant patients with HBeAg(+) hepatitis B

Objective To evaluate the efficacy of adefovir dipivoxil(ADV) in the treatment of lamivudine-resistant patients with HBeAg(+) hepatitis B.Methods seventy-eight lamivudine-resistant patients were randomly assigned to combination therapy(10 mg ADV once daily plus ongoing LAM at 100 mg once daily ) or 10 mg ADV monotherapy once daily(n=38).normalization of alanine aminotransferase,HBeAg loss,HBeAg seroconversion,undetectable HBV DNA were assessed at 24 and 48 weeks.Results At 24 and 48 weeks after treatment,the rate of undetectable HBV DNA was significantly higher in the ADV plus LAM group than in the ADV monotherapy group,(60.0% vs 34.2%,P0.05),(77.5% vs 50.0%,P0.05).On the contrary,the rate of ALT normalization,HBeAg loss and seroconversion were all similar between ADV plus LAM and ADV groups(all P 0.05).Conclusion Adding-on or switch to ADV was both effective in the treatment of lamivudine-resistant patients with HBeAg(+) hepatitis B.The combination of ADV with LAM was superior in inhibiting HBV replication as compared to ADV alone for lamivudine-resistant CHB patients.