干扰素α-1b和拉米夫定序贯治疗慢性乙型肝炎的高水平HBV清除动力学观察

Objective To observe the efficacy of sequential therapy with interferon α-1b (IFNα-1b) and lamivudine on treatment of chronic hepatitis B with high level HBV DNA.Methods 76 patients with HBeAg positive and HBV DNA>1×107 copies/ml were randomly divided into 2 groups.The treatment group (n=40) were treated with Lamivudine for 4 weeks, lamivudine plus IFN α1b for 8 weeks and IFN α-1b alone for 16 weeks.The control group (n=36) was given IFN α-1b alone for 24 weeks.Before and after treatment, hepatic function, blood test, viral markers and HBV DNA of the 2 groups were detected respectively.Results At the end of treatment, the rate of normal ALT, the negative rate of HBV DNA and HBeAg, and the positive rate of HBeAb were higher in treatment group than control group (P<0.05;P<0.01) .The efficacy rate of the treatment group (72.5%) was higher than that of the control group (50.0%) .There was no significant different in adverse effects between the 2 groups (P>0.05) .After 6 months follow up, those were still higher in the treatment group than the control group (P<0.05) , but there was no obvious significant different in the positive rate of HBeAb between the 2 groups (P>0.05) .Conclusion Sequential therapy with IFN α-1b and lamivudine has good therapeutic efficacy in treatment of chronic hepatitis B with high level HBV DNA and is superior to IFN α-1b alone.