A clinical study of denovo combination therapy with lamivudine(LAM) and adefovir dipivoxil(ADV) in the treatment of patients with decompensated cirrhosis related to HBV
Objective To evaluate the efficacy of denovo combination therapy with lamivudine(LAM) and adefovir dipivoxil(ADV) in the treatment of patients with decompensated cirrhosis related to HBV. Methods 28 patients with decompensated cirrhosis related to HBV were given LAM combined with ADV(the denovo combination group); 26 cases were only given LAM(monotherapy of LAM). Basic approaches including liver protection, symptom-driven intervention, and supporting therapy, were given to all of the individuals. A course of two-year was applied to all. Virology, biochemistry and serology changes were observed pro-and post-treatment in different time point. Results The undetectable rates of HBVDNA at month 12, 24 were 85.7%, 92.9%, respectivly for the denovo combination group, and(61.5%, 65.4%) for the monotherapy of LAM group(P<0.05). After 24 months treatment, the rates of HBeAg seroconversion were 64.3% for the denovo combination group, and 34.6% for the LAM group(P<0.05). The recover rate of ALT of two groups in different time point has no significant difference P>0.05). Biochemical index in the same period of the two groups has no significant difference(P>0.05). Virological mutation occurred to none in denovo combination group, and 11.5%(3/26) and 23.1%(6/26) respectively at 12 and 24 months in LAM group. Elevated level of sCr didn't arised at the end of treatment in two groups. Conclusion Present study reveals that denovo combination therapy of LAM and ADV is superior to monotherapy of LAM in virological, serological response and HBV drug resistance mutation, also the renal safety is favorable, is worthy of clinical application.
NETL
NSTL
万方数据
维普
