联合用药对阿德福韦单药治疗应答不佳的E抗原阳性慢性乙型肝炎患者的疗效观察

目的评价恩替卡韦联合阿德福韦对阿德福韦单药治疗应答不佳的E抗原阳性慢性乙肝患者的疗效。方法共25例经过阿德福韦单药治疗1年而HBV DNA仍大于1000拷贝/ml的慢性乙肝患者被纳入,并且采用阿德福韦联合恩替卡韦治疗作为优化治疗方案。结果患者在恩替卡韦联合阿德福韦治疗开始后的第3个月和第6个月,HBV DNA阴转率分别达到68%和92%,生化学应答率分别达到76%和96%,E抗原消失率分别是8%和12%,E抗原血清学转换率分别是4%和8%。在6个月的联合治疗观察期内,所有患者耐受良好,未发生任何不良事件。结论采用恩替卡韦联合阿德福韦进行优化治疗对于阿德福韦单药治疗应答不佳的E抗原阳性慢性乙肝患者是一种较好的选择。

Clinical observation of entecavir and adefovir combination therapy in HBeAg-positive chronic hepatitis B patients with poor response to adefovir monotherapy

Objective This study aimed to evaluate the efficacy of entecavir（ETV） and adefovir（ADV） combination therapy in patients with HBeAg-positive chronic hepatitis B（CHB） and poor response to ADV monotherapy.Methods 25 CHB patients with HBV DNA more than 〈1000 copies/ml after 1 year of ADV monotherapy were included and received ETV plus ADV for more than 6 months.Results Patients with ETV plus ADV had an improved response rate at both month 3 and 6.The rate of HBV DNA negativity（HBV DNA level 1000 copies/mL） was 68%（17/25） and 92%（23/25） at month 3 and 6,respectively.The biochemical response rate was 76%（19/25） and 96%（24/25）,respectively.The HBeAg loss rate was 8%（2/25） and 12%（5/25）,respectively.HBeAg seroconversion rate was 4%（1/25） and 8%（2/25）,respectively.During the first 6 months of combination therapy,all patients were well tolerated and no adverse reaction was reported.Conclusion The combination of ETV and ADV is a good choice for CHB patients who have a poor response to ADV monotherapy.