Analysis of therapeutic effect of adefovir dipivoxil in continued treatment of chronic hepatitis B patients with poor early virological response to initial treatment

Objective To explore the safety and therapeutic effect of adefovir dipivoxil in continued treatment of chronic hepatitis B patients with poor early virological response to initial treatment or with failure treatment and to reduce nucleoside medication abuse.Methods All the 120 chronic hepatitis B patients took 10 mg of adefovir dipivoxil as oral dose once a day.The patients without clearance of HBV DNA after 12 weeks treatment with adefovir dipivoxil would be studied and be divided into three groups on the basis of HBV DNA level.They would take adefovir dipivoxil at increased oral dose once a day for another 12 weeks for further observation.Results 94 of 120 patients completed 24 weeks of treatment.The cumulative clearance rate of serum HBV DNA was 71/120 (59.17%) in patients with treatment for 24 weeks and 26/120 (21.67%) in patients with treatment for 12 weeks, χ2=5.837, P<0.05.There was no significant difference in serum creatinine level among the groups (P>0.05) .Conclusion By increasing oral dose of adefovir dipivoxil to 15mg or 20mg once a day and prolonging the treatment time to 24 weeks, the clearance rate of level of serum HBV DNA of patients with poor early virological response in initial treatment can be raised.The significant elevations in serum creatinine level has not been observed and clinical trial sample should be large enough to certify it.