title: Cost-effectiveness of Lamivudine, Telbivudine, Adefovir Dipivoxil and Entecavir on decompensated hepatitis B virus-related cirrhosis.
abstract: OBJECTIVE
  To evaluate the cost-effectiveness of lamivudine (LMV), telbivudine (LdT), adefovir dipivoxil (ADV) and entecavir (ETV) on decompensated hepatitis B virus-related cirrhosis.
  
  
  METHODS
  1332 patients with decompensated hepatitis B virus-related cirrhosis were randomly assigned into 5 groups with different clinical treatment including LMV treatment, LdT treatment, ADV treatment, LMV+ADV treatment and ETV treatment. And then the liver function, Child-Pugh scores, sero-conversion of HBeAg/HBeAb, polymerase gene mutations, cost-effectiveness, incremental cost-effectiveness and side effects were investigated and further analyzed.
  
  
  RESULTS
  LMV, ADV, LdT, LMV+ADV and ETV were all effective on decreasing Child-Pugh scores and conversing negatively hepatitis B virus (HBV) DNA and HBeAg, whereas LMV+ADV and ETV more effective than LMV, ADV and LdT. HBV DNA polymerase genotypic mutations were rare in the 5 groups. The less mutation rate was found in the LMV+ADV and ETV group than in the LMV, ADV and LdT group. Compared to the cost-effectiveness and incremental cost-effectiveness ratio, ETV was the optimal selection, LMV+ADV was the alternative selection and LMV was the cheapest option. The side effects of the 5 plans were all rare and could be controlled.
  
  
  CONCLUSIONS
  LMV, ADV, LdT, LMV+ADV and ETV were all effective on treatment of decompensated hepatitis B virus-related cirrhosis whereas ETV and LMV+ADV were recommended.
authors.affiliation: Department of Digestive Internal Medicine, 307 Hospital of PLA, Beijing, People's Republic of China. xiaoxz26@126.com.
authors.forename: G-L
authors.initials: GL
authors.lastname: Wang
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
authors.forename: P
authors.initials: P
authors.lastname: Qiu
authors.forename: S-F
authors.initials: SF
authors.lastname: Zhou
authors.forename: L-F
authors.initials: LF
authors.lastname: Xu
authors.forename: P
authors.initials: P
authors.lastname: Wen
authors.forename: J-B
authors.initials: JB
authors.lastname: Wen
authors.forename: X-Z
authors.initials: XZ
authors.lastname: Xiao
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000191:economics* / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000187:drug effects; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000191:economics*; D006801:Humans; D019259:Lamivudine / Q000191:economics / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000191:economics* / Q000821:virology; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000191:economics / Q000627:therapeutic use; D000077712:Telbivudine; D013936:Thymidine / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D000077712:Telbivudine; D019259:Lamivudine; C413685:entecavir; D006147:Guanine; D000225:Adenine; C106812:adefovir dipivoxil; D013936:Thymidine