title: [Therapeutic effect of antiviral regimens for chronic hepatitis B refractory to lamivudine plus adefovir].
abstract: OBJECTIVE
  To compare the efficacy and safety of recombinant human interferon α-2b (INFα-2b) monotherapy and combined therapy with entecavir (ETV) plus adefovir dipivoxil (ADV) in chronic hepatitis B patients with poor response to combined therapy with lamivudine and ADV.
  
  
  METHODS
  A total of 161 patients with chronic hepatitis B refractory to to combined therapy with lamivudine (LAM) and ADV were randomized to receive INFα-2b monotherapy (5×10(6), three times a week) (group A) or combined therapy with entecavir (0.5 mg/day) plus adefovir (10 mg/day) (group B). Serum levels of HBsAg, HBeAg and HBV viral load were analyzed at 48 weeks using chemiluminescence assay and by real-time PCR as appropriate. The drug resistance genes in HBV was tested by direct DNA sequencing.
  
  
  RESULTS
  At 48 weeks of treatment, HBV DNA decreased significantly in groups A and B to 2.06∓1.15log10 copies/ml and 1.77∓1.28log10 copies/ml, respectively. The rates of viral response, serological response, and biochemical response in groups A and B were 48.15% (39/81) vs 53.75% (43/80), 61.70% (50/81) vs 53.75% (43/80), and 49.38% (40/81) vs 60.00% (48/80), showing no significant differences between the two groups (P>0.05). The drug resistance gene mutation rate was significanty higher in group B (64.86%, 24/37) than in group A (30.95%, 13/42, P<0.05).
  
  
  CONCLUSIONS
  Chronic hepatitis B patients refractory to lamivudine combined with ADV have a good response to INFα-2b monotherapy and combined therapy with entecavir and ADV , and interferon treatment is preferred to reduce potential drug resistance gene mutations.
authors.affiliation: Department of Liver Diseases, Jiujiang Third People's Hospital, Jiujiang 332000, China. E-mail: 936619910@qq.com.
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.forename: Jingyu
authors.initials: J
authors.lastname: Wu
authors.forename: Guanjun
authors.initials: G
authors.lastname: Xu
authors.forename: Qin
authors.initials: Q
authors.lastname: Zhang
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Chen
authors.forename: Zhenhua
authors.initials: Z
authors.lastname: Liu
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D024882:Drug Resistance, Viral; D004359:Drug Therapy, Combination; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000187:drug effects*; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D019259:Lamivudine; D009154:Mutation; D063065:Organophosphonates / Q000627:therapeutic use*; D060888:Real-Time Polymerase Chain Reaction; D011994:Recombinant Proteins / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D063065:Organophosphonates; D011994:Recombinant Proteins; D019259:Lamivudine; C413685:entecavir; D006147:Guanine; D000225:Adenine; C106812:adefovir dipivoxil