The Efficacy of Adefovir Plus Entecavir Combination Therapy in Patients with Chronic Hepatitis B Refractory to Both Lamivudine and Adefovir

作者：Cho Yuri; Lee Dong Hyeon; Chung Kwang Hyun; Jin Eunhyo; Lee Jeong Hoon; Cho Eun Ju; Yu Su Jong; Kim Jin Wook; Jeong Sook Hyang; Yoon Jung Hwan; Lee Hyo Suk; Kim Chung Yong; Kim Yoon Jun^*

来源：Digestive Diseases and Sciences, 2013, 58(5): 1363-1370.

DOI：10.1007/s10620-012-2480-1

• Chronic hepatitis B
• Entecavir
• Adefovir
• Combination therapy
• Drug resistance

The efficacy of adefovir (ADV) plus entecavir (ETV) combination in patients with chronic hepatitis B (CHB) who developed multidrug refractoriness had not been fully evaluated. We aimed to evaluate the efficacy of ADV plus ETV as compared to that of lamivudine (LAM) plus ADV in the patients with antiviral refractoriness to sequential LAM monotherapy and then ADV monotherapy.
Twenty-seven patients were treated with a combination of ADV plus ETV and 63 patients were treated with a combination of LAM plus ADV. The virological and biochemical parameters were compared between the two groups, retrospectively.
Treatment with a combination of ADV plus ETV produced significantly superior virological response than that of a combination of LAM plus ADV. At 12 months, the HBV DNA declined more in the ADV plus ETV group than in the LAM plus ADV (-4.52 +/- A 1.956 vs. -2.65 +/- A 1.723 log(10)IU/mL; p = 0.001). The rate of a complete response at 12 months was greater in the ADV plus ETV group than that in the LAM plus ADV group (63.16 vs. 14.81 %, p < 0.001).
In the patients with CHB refractory to both LAM and ADV, the response to ADV plus ETV was significantly superior compared to that of the LAM plus ADV in suppressing HBV DNA. The result indicates that ADV plus ETV can be used as a bridging therapy in the patients with refractoriness to both LAM and ADV, especially in the areas where tenofovir is not yet available.

• 出版日期2013-5