Efficacy of Telbivudine Combined with Defovir Dipivoxil on Positive-HBeAg Chronic Hepatitis B Patients with Suboptimal Response to Adefovir Dipivoxil

Objective To evaluate the curative efficacy of telbivudine combined with defovir dipivoxil on positive-HBeAg chronic hepatitis B patients with suboptimal response to adefovir dipivoxil.Methods A total of 26 HBeAg-positive patients with suboptimal response to adefovir dipivoxil(treated with adefovir dipivoxil for more than 12 months) were treated with adefovir dipivoxil 10 mg in addition to telbivudine 600 mg between June 2008 and August 2009.Liver function and serum hepatitis B virus(HBV) DNA tests were assessed at the baseline and 3-month intervals,whereas HBV serological markers and abdominal ultrasonography were carried out every 6 months.Results During the first year of treatment,all patients showed a progressive decline of serum HBV DNA levels;while undetectable serum HBV DNA and normalization of alanine aminotransferase was achieved in 24(92.3%) and 25(96.2%) patients,respectively,at the end of the first year of treatment.The 6-and 12-month cumulative rates of HBeAg loss were 26.9%(7/26) and 42.3%(11/26),respectively;and corresponding cumulative rates of HBeAg/anti-HBe seroconversion were 7.7%(2/26) and 30.8(8/26),respectively.During the observation period,no virological breakthrough was detected.Conclusion Telbivudine combined with defovir dipivoxil may be a good choice for patients with suboptimal response to adefovir dipivoxil,which could induce effective viral inhibition and help patients obtain more virological,biochemical and immunological responses.