1Department of Infectious Diseases, The Third Affiliated Hospi...

The aim of this study was to evaluate the efficacy and safety of entecavir ETV combined treatment with adefovir ADV on chronic hepatitic B CHB patients who failed to respond to nucleotide acid analog NA treatment On this basis the possible factors in the combined treatment of these patients will be analyzed The safety biochemical index and the possible factors that might affect the ETV and ADV combined treatment at different points in time were retrospectively analyzed The biochemical index included the following virological response hepatitis B virus HBV DNA decline primary nonresponse biochemical response and the hepatitis B virus E antigen hepatitis B virus E antibody seroconversion rate There were 94 CHB patients and compensated liver cirrhosis patients who received ETV plus ADV treatment for over 12 weeks after failure of treatment with NAs The authors have also investigated 76 CHB patients 80 9 and 18 hepatitis B cirrhosis patients 19 1 in this study The HBV DNA baseline was 4 4 1 4 log10 IU mL and the positive rate of HBeAg before salvage treatment was 78 7 74 94 The sample sizes were 94 78 42 10 6 and 1 for follow-up of 24 48 96 144 192 and 240 weeks respectively The virological responses HBV DNA 2 log10 IU mL and biochemical responses were 52 1 74 3 and 90 4 and 63 1 61 6 and 81 1 respectively at 24 48 and 96 weeks which showed significant differences P 0 001 and P 0 005 respectively The HBV DNA decline was presented as mean SEM which were 1 53 1 23 1 75 1 37 2 07 1 54 and 2 39 1 77 log10 IU mL at 12 24 48 and 96 weeks respectively They showed significant differences compared with the baseline 8 084 P 0 05 The rate of primary nonresponse was 30 9 29 94 and the primary treatment failure rates were 26 6 25 94 24 4 19 78 and 4 8 2 42 at 24 48 and 96 weeks respectively They all have statistical difference P 0 011 0 05 There were 23 patients who experienced virological breakthrough after the HBV DNA levels were undetectable whereas after follow-up for 12-24 weeks the HBV DNA levels were back to undetectable again ETV plus ADV treatment is an efficient and safe treatment for CHB and compensated liver cirrhosis patients who experienced NA treatment failure The high quantity of baseline HBV DNA level is a risk factor for poor efficacy of salvage treatment

1Department of Infectious Diseases, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; 2Clinical Department, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China; and 3Department of Infectious Diseases, The Fi

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Entecavir Combined With Adefovir Ameliorates Patients With Chronic Hepatitis B Who Fail to Respond to Nucleotide (Acid) ...