停止拉米夫定治疗后,病毒复发的慢性乙型肝炎患者,拉米夫定加阿德福韦是一个很好的选择，
Background and Aim: Currently, there is no consensus on the retreatment recommendation of chronic hepatitis B (CHB) patients with viral rebound after cessation of treatment. In the search of reasonable treatment, we compared the efficacy and safety of adefovir (ADV) plus LAM and LAM alone for the retreatment of patients with viral relapse but without genotypic resistance after cessation of LAM.
Methods: This is a prospective controlled study, and a total of 53 hepatitis B e antigen (HBeAg)-positive patients with viral rebound but without resistance were received either LAM plus ADV or LAM alone treatment.
Results: After 1-year treatment, More patients who received LAM plus ADV than those who received LAM alone had ALT normalization (84% versus 53.6%, P=0.018) or HBV DNA levels below 1000 copies/mL (80% versus 42.9%, P<0.006).
Seven patients receiving LAM plus ADV had HBeAg seroconversion, as compared with 0 in patients receiving ALM alone (28% versus 0%, P=0.003). During 1-year retreatment, five patients receiving LAM alone had virological breakthrough and all of them had LAM resistance strains (rtM204V/I), while no LAM- or AD- associated resistance strains were detected in patients receiving LAM plus ADV.
All patients receiving LAM plus ADV were well tolerated, and no serious side effects were noted.
Conclusions: Patients treated with LAM plus ADV exhibited significantly greater virological, biochemical and serological responses compared with LAM alone. These data suggest that combination of LAM plus ADV would be a good option for the retreatment of CHB patients with viral relapse after cessation of LAM.
