Objective To investigate the efficacy and safety of entecavir (ETV) combined with adefovir (ADV) in chronic hepatitis B (CHB) patients with high viral load. Methods Eighty CHB patients with high viral load who were admitted to our hospital from December2008 to December 2011 were equally and randomly divided into observation group and control group. The control group was given ETV, while the observation group was treated with ETV combined with ADV. HBV DNA load, HBsAg or HBeAg seroconversion, alanine aminotransferase (ALT) normalization, and adverse reactions before and after 3, 6, 12, and 24 months of treatment were evaluated. Comparison of continuous data between the two groups was made by independent- samples t test, and comparison of categorical data was made by chi- square test. Results Compared with the control group, the observation group had significantly lower HBV DNA load after 6, 12, and 24 months of treatment (3.7 ±0.3 vs3.4 ±0.4 log copies/ml, t =3.339, P<0.05;2.9 ±0.4 vs2.6 ±0.3 log copies/ml, t =5.657, P <0.05;1.6 ±0.7 vs1.2 ±0. 4 log copies /ml, t = 2. 806, P < 0. 05) . The HBV DNA clearance rate and HBeAg clearance rate in observation group were significantly higher than those in control group after 12 months of treatment (87. 5% vs 70. 0%, P < 0. 05; 80. 0% vs 55. 0%, P < 0. 05) and 24 months of treatment (95. 0% vs 77. 5%, P < 0. 05; 90. 0% vs 70. 0%, P < 0. 05) . The observation group had significantly higher HBeAg seroconversion rate and ALT normalization rate than the control group after 24 months of treatment (77. 5% vs 50. 0%, P < 0. 05; 82. 5% vs 55. 0% P <0. .="" during="" the="" there="" was="" no="" significant="" difference="" in="" incidence="" of="" adverse="" reactions="" between="" two="" groups="" p="">0. 05) , but the observation group had a significantly lower viral breakthrough rate than the control group (0 vs 10. 0%, P < 0. 05) . Conclusion For CHB patients with high viral load, ETV combined with ADV has strong antiviral activity, reduces drug resistance and poor response, and shows better long- term clinical efficacy than ETV alone, suggesting that it is a safe and reliable therapy.
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