Efficacy of add- on adefovir dipivoxil at week 12 /24 in HBe Ag- positive chronic hepatitis B patients during PEG-IFNα therapy

Objective To investigate the efficacy of add- on adefovir dipivoxil( ADV) at week 12 /24 in HBe Ag- positive chronic hepatitis B( CHB) patients with hepatitis B virus( HBV) DNA levels of ≥105copies / ml during pegylated interferonα( PEG- IFNα) therapy.Methods A retrospective analysis was performed on 74 HBe Ag- positive CHB patients,who had HBV DNA levels of ≥105copies / ml after12 weeks of PEG- IFNα treatment in The First Affiliated Hospital of Fujian Medical University from October 2009 to January 2014. These patients were divided into group A( n = 36),which was given ADV at week 12 of PEG- IFNα treatment,group B( n = 19),which was given ADV at week 24 of PEG- IFNα treatment,and group C( n = 19),which was not given ADV during the PEG- IFNα treatment. The combined response rate after 48 weeks of treatment was compared between the three groups,and the influencing factors for treatment outcome were investigated. Comparison of continuous data( mean ± SD) between the three groups was made by one- way analysis of variance,and comparison of categorical data was made by chi- square test. The receiver operating characteristic curve and multivariate Cox logistic analysis were used to evaluate the predictive values of these parameters. Results After 48 weeks of treatment,the combined response rate of group A( 27. 78%,10 /36) was significantly higher than those of group B( 5. 26%,1 /19) and group C( 5. 26%,1 /19)( both P =0. 045). The negative predictive values of HBe Ag decrease at week 12,HBe Ag decrease at week 24,and HBV DNA decrease at week 24 for combined response were 90. 0%,94. 44%,and 94. 55%,respectively. HBV DNA level at week 24 < 103 copies / ml and HBe Ag decrease at week 24 > 1. 06 log10 S / CO were independent predictive factors for combined response. Conclusion Add- on ADV therapy could increase the 48- week combined response rate of HBe Ag- positive CHB patients who have HBV DNA levels of ≥105copies / ml after 12 weeks of PEG- IFNα treatment. The HBV DNA and HBe Ag decreases at week 24 have high negative predictive values for combined response.