2015•Chin J Clin Infect DisRequires access
Clinical efficacy of entecavir monotherapy and combination of entecavir and adefovir dipivoxil for HBeAg-positive chronic hepatitis B patients with suboptimal response to adefovir dipivoxil
Haijun Chen, Hong Yan Qiao, Yinggang Chen, Jianming Wang, Qing Yuan, Ping Wu, Qiyue Sheng, Yuxiang Guo
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Abstract
Objective
To observe the efficacy and safety of entecavir (ETV) monotherapy and combination of ETV and adefovir dipivoxil (ADV) in treatment of HBeAg-positive chronic hepatitis B (CHB) patients with suboptimal response to ADV.
Methods
A total of 82 CHB patients with HBeAg-positive who demonstrated suboptimal responses to ADV monotherapy were enrolled from Jinhua Central Hospital in Zhejiang Proince during January 2010 and June 2013. Patients were randomly divided into ETV group (n=34) and ETV + ADV group (n=48). Normalization rates of alanine aminotransferase (ALT) and total bilirubin (TBil), negative conversion rates of HBeAg and HBV DNA, seroconversion rate of HBeAg and adverse reactions were observed at 12-, 24-, 48-, 72- and 96-week of treatment. Chi-square test or t-test was used for data analysis.
Results
At 96-week of treatment, the normalization rates of ALT and TBil in ETV group were 97.06% (33/34) and 94.12% (32/34), while those in ETV+ ADV group were 97.92% (47/48) and 97.92% (47/48), respectively (χ2=0.000 and 0.093, all P>0.05). The negative conversion rates of HBeAg, HBV DNA, and the seroconversion rate of HBeAg in ETV group were 23.53% (8/34), 94.12% (32/34) and 11.76% (4/34), while those in ETV+ ADV group were 22.92% (11/48), 97.92% (47/48) and 14.58% (7/48), respectively (χ2=0.004, 0.093 and 0.093, all P>0.05). No obvious adverse reaction was observed during the treatment in both groups, but the average medical cost in ETV group (20 035.2 Yuan) was lower than that in ETV+ ADV group (30 636.96 Yuan).
Conclusion
Both ETV monotherapy and combined use of ETV and ADV have satisfactory clinical efficacy for HBeAg-positive CHB patients with suboptimal response to ADV, and ETV monotherapy is a better option since it is more economical.
Key words:
Hepatitis B, chronic; Entecavir; Adefovir dipivoxil; Antiviral agents; Treatment outcome