Efficacy of telbivudine combined with adefovir dipivoxil and pegylated interferon combined with entecavir as antiviral therapy for chronic hepatitis B: a comparative analysis / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the efficacy of telbivudine combined with adefovir dipivoxil and PEG-IFN-α-2a combined with entecavir as the antiviral therapy for HBeAg-positive patients with chronic hepatitis B (CHB) and a high viral load. MethodsA total of 80 previously untreated HBeAg-positive CHB patients with a high viral load who were treated in The Sixth People′s Hospital of Qingdao from November 2012 to November 2015 were enrolled and randomly divided into two groups. The patients in group A were treated with telbivudine combined with adefovir dipivoxil, and those in group B were treated with PEG-IFN-α-2a combined with entecavir. Biochemical and virologic response rates and seroconversion rate were observed at weeks 12, 24, and 48 of administration. The drug resistance rate and incidence rates of adverse events were observed in both groups. The Chi-square test was applied for comparision of categorical data between the two groups, and the t-test was applied for comparision of continuous data between the two groups. ResultsBiochemical and virologic response rates at weeks 12, 24, and 48 of administration showed no significant differences between the two groups. The seroconversion rates at weeks 12 and 24 of administration showed no significant differences between the two groups, while at week 48 of administration, group B had significantly higher HBeAg clearance rate and seroconversion rate than group A (450% vs 675%， 225% vs 450%，χ2=4.114 3 and 4.528 3, both P＜0.05). Group B had significantly higher incidence rates of adverse events than group A. ConclusionTelbivudine combined with adefovir dipivoxil and PEG-IFN-α-2a combined with entecavir can effectively inhibit the replication of high-load HBV DNA, delay disease progression, and realize HBeAg seroconversion. However, the two regimens have their own advantages and disadvantages and should be selected according to clinical situation.