Abstract:
Objective To investigate the therapeutic effect of two drug regimens on lamivudine-resistant chronic hepatitis B.
Methods A total of 150 patients with lamivudine-resistant chronic hepatitis B admitted from September 2016 to June 2021 were selected as research objects and randomly divided into observation group and control group, with 75 cases in each group. The control group was treated with adefovir dipivoxil combined with entecavir, while the observation group was treated with tenofovir disoproxil fumarate monotherapy. The negative conversion rate of hepatitis B virus deoxyribonucleic acid (HBV-DNA) was compared between the two groups; the changes of liver function indexes and liver fibrosis indexes before and after treatment as well as the occurrence of adverse reactions were observed in the two groups.
Results After 12, 24 and 48 weeks of treatment, the HBV-DNA negative conversion rates of the observation group were 61.33%, 78.67% and 93.33%, respectively, which were significantly higher than 36.00%, 57.33% and 77.33% of the control group (P < 0.05). After 48 weeks of treatment, the levels of serum aspartate aminotransferase (AST), total bilirubin (TBIL) and alanine aminotransferase (ALT) as well as serum laminin (LN), type Ⅳ collagen (Ⅳ-C) and type Ⅲprocollagen (PCⅢ) levels in the two groups were significantly lower than those before treatment, and were significantly lower in the observation group than those of the control group(P < 0.05).The incidence of adverse reactions was 17.33% in the observation group and 21.33% in the control group, and there was no significant difference between the two groups (P>0.05).
Conclusion Compared with adefovir dipivoxil combined with entecavir, tenofovir disoproxil fumarate monotherapy is more effective in the treatment of lamivudine-resistant chronic hepatitis B patients, which can significantly improve their liver function and liver fibrosis indexes, and has good safety and high clinical value.