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首页> 外文期刊>Journal of viral hepatitis. >Efficacy and safety of telbivudine plus adefovir dipivoxil combination therapy and entecavir monotherapy for HBeAg-positive chronic hepatitis B patients with resistance to adefovir dipivoxil
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Efficacy and safety of telbivudine plus adefovir dipivoxil combination therapy and entecavir monotherapy for HBeAg-positive chronic hepatitis B patients with resistance to adefovir dipivoxil

机译：替比夫定联合阿德福韦酯联合恩替卡韦单药治疗HBeAg阳性慢性乙型肝炎对阿德福韦酯耐药的疗效和安全性

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摘要

The objective of this study was to compare the efficacy and safety of two rescue strategies for hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) patients with resistance to adefovir dipivoxil (ADV). This prospective study included 58 HBeAg-positive CHB patients with resistance to ADV; 30 patients underwent telbivudine (LdT) plus ADV combination therapy and 28 patients switched to entecavir (ETV) monotherapy. After 48 weeks of treatment, the rates of hepatitis B virus (HBV) DNA 3 log10 copies/mL in the LdT plus ADV group and the ETV group were not significantly different (73.3% vs 57.1%, P = 0.195). Six patients receiving LdT plus ADV had HBeAg seroconversion, while none of the patients receiving ETV alone had HBeAg seroconversion (20% vs 0%, P = 0.039). During the 48-week treatment period, two patients in the ETV monotherapy group had viral breakthrough and the strains were confirmed to be of a variant associated with ETV resistance (rtM204V+ rtL180M+ rtT184G), while one patient receiving LdT plus ADV had viral breakthrough and an LdT-associated resistance mutation (rtM204I) was detected. For the majority of the patients, both LdT plus ADV combination treatment or ETV monotherapy were generally well tolerated, and no serious side effects were observed. Both LdT plus ADV combination therapy and ETV monotherapy led to significant decreases in serum HBV DNA in HBeAg-positive CHB patients with resistance to ADV, and LdT plus ADV combination therapy exhibited a significantly higher rate of HBeAg seroconversion compared with ETV monotherapy.
机译：本研究的目的是比较两种对阿德福韦酯（ADV）耐药的乙型肝炎e抗原（HBeAg）阳性的慢性乙型肝炎（CHB）抢救策略的有效性和安全性。这项前瞻性研究纳入了58例对ADV耐药的HBeAg阳性CHB患者。 30例患者接受替比夫定（LdT）加ADV联合治疗，而28例患者改用恩替卡韦（ETV）单药治疗。治疗48周后，LdT加ADV组和ETV组的乙型肝炎病毒（HBV）DNA <3 log10个拷贝/毫升的比率无显着差异（73.3％对57.1％，P = 0.195）。接受LdT加ADV的6例患者发生了HBeAg血清转化，而仅接受ETV的患者均未发生HBeAg血清转化（20％vs 0％，P = 0.039）。在48周的治疗期内，ETV单药治疗组的两名患者出现了病毒突破，该菌株被确认为具有ETV耐药性的变异株（rtM204V + rtL180M + rtT184G），而接受LdT加ADV的一名患者出现了病毒突破，检测到与LdT相关的抗性突变（rtM204I）。对于大多数患者，LdT加ADV联合治疗或ETV单药治疗通常耐受良好，并且未观察到严重的副作用。 LdT加ADV联合疗法和ETV单一疗法均导致对ADV耐药的HBeAg阳性CHB患者的血清HBV DNA显着降低，并且LdT加ADV联合疗法与ETV单一疗法相比，HBeAg血清转化率明显更高。

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