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Objective To investigate the genotypes and resistance loci in patients with chronic hepatitis B(CHB) achieving virologic breakthrough in the treatment with lamivudine (LAM) combined with adefovir (ADV) after developing drug resistance in the treatment with LAM alone. Methods A total of 89 CHB patients who were admitted to Henan Provincial People′s Hospital and treated with LAM and ADV as the antiviral therapy after developing drug resistance in the treatment with LAM alone from June 2010 to June 2013 were enrolled, and their serum samples were collected. Quantitative real-time PCR was used for hepatitis B virus (HBV) detection, and sequencing was applied to determine the genotype and detect the resistance loci rtN236T, rtA181V, rtM204V, and rtL180M. The t-test was applied for comparison of continuous data between groups, and the chi-square test was applied for comparison of categorical data between groups. Results LAM rtM204V mutation was detected in all the 89 patients after treatment with LAM alone. After the combination therapy with LAM and ADV, ADV rtN236T mutation was detected in 9 patients, ADV rtA181V mutation in 5 patients, and rtN236T+rtA181V mutation in 8 patients, with an overall ADV resistance rate of 24.7% (22/89). As for HBV genotyping, 82 patients had genotype C, and rtA181V+rtN236T mutation was detected in 8 patients; 7 patients had genotype B. Conclusion Compared with the patients with HBV genotype B, the patients with genotype C are more susceptible to rtA181V+rtN236T mutation during the combination therapy with LAM and ADV after developing drug resistance in the treatment with LAM alone. [ABSTRACT FROM AUTHOR]

Objective: To compare the curative effect of lamivudine and adefovir on the treatment of chronic hepatitis B. Methods:A retrospective analysis was conducted on the clinical data of 80 cases with chronic hepatitis B who were treated in our hospital from May 2012 to 2014, and the patients were randomly divided into the study group and the control group with 40 cases in each group. The patients in the study group were treated with adefovir, while the patients in the control group were treated with lamivudine. Then the recovery rate of liver function, negative rate of viral burden and HBe Ag, the reduction rate of granulocyte and the incidence of adverse reactions of patients in the two groups were observed and compared. Results: The recovery rate of liver function, negative rate of viral burden and HBe Ag of patients in the study group were higher than those of the patients in the control group with statistically significant differences(P<0.05), while there was no significant difference about the reduction rate of granulocyte between the two groups(P>0.05);The inhibition of HBV-DNA of patients in the study group was higher than that of the control group with statistically significant differences(P<0.05); There was no statistically significant difference about the adverse reactions between the two groups(P>0.05).Conclusion: It is indicated that the clinical effects of adefovir should be better on treatment of chronic hepatitis B with obvious efficacy and high safety. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the efficacy of lamivudine combined with adefovir in treatment of chronic hepatitis B (CHB) with tyrosine-methionine-aspartate-aspartate (YMDD) mutation. METHODS: After treatment with lamivudine, 108 cases of patients with CHB with YMDD mutation admitted into the First People’s Hospital of Yidu from Jan. 2012 to Jan. 2016 were selected to be divided into observation group and control group via the random number table，with 52 cases in each. The control group was treated with adefovir, while the observation group additionally received lamivudine based on the control group. Changed of liver function indicatorsin two groups were compared，the negative rate of HBV DNA and HBeAg and YMDD mutation of two groups were compared. RESULTS： After treatment， the serum ALT，AST and TBIL of two groups decreased significantly compared with before treatment，and observation group were significantly lower than control group，with statistically significant difference (P <0. 05). The negative rate of HBV-DNA and HBeAg in observation group was significantly higher than that of control group，yet the rate of YMDD mutation was lower than that of control group， with statistically significant difference (P < 0. 05). There were no obvious adverse drug reactions in two groups. CONCLUSIONS： The efficacy of lamivudine combined with adefovir in treatment of chronic hepatitis B with YMDD mutations remarkable，with high safety. [ABSTRACT FROM AUTHOR]

Obj'ective To compare treatment outcome, drug resistance rate, and safety between initial combination therapy with lamivudine (LAM ) plus adefovir dipivoxil (ADV ) and monotherapy with entecavir (ETV ) in the treatment of HBeAg - positive chronic hepatitis B ( CHB ) . Methods Fifty - six HBeAg - positive CHB patients, who received treatment in The First People's Hospital of Foshan from May 2008 to February 2010, were divided into combination therapy group and monotherapy group using a random number table. The combination therapy group received LAM (100 mg/d ) plus ADV (10 mg/d ) once daily for 48 weeks, while the monotherapy group received ETV (0.5 mg/d ) once daily for 48 weeks. Te alanine aminotransferase (ALT ) normalization rate, hepatitis B virus (HBV ) DNA clearance rate, and HBeAg clearance rate were compared between the two groups by chi - square test. Results After 48 weeks of treatment, the ALT normali-zation rate showed no significant difference between the two groups (?² =1.018, P>0.05 ), but after 36 weeks of treatment, the ALT nor-malization rate was significantly higher in the monotherapy group than in the combination therapy group (?² =4.082, P <0.05) . After 12 and 48 weeks of treatment, the HBV DNA clearance rate showed no significant diference between the two groups (?² = 1. 167, P >0.05; ?² =1.976, P >0.05), but after 24 and 36 weeks of treatment, the HBV DNA clearance rate was significantly higher in the monotherapy group than in the combination therapy group (?² = 5.600, P < 0. 05 ; ?² = 9.164, P<0.05) . There was no significant diference in HBeAg clearance rate between the two groups. over the course of treatment, neither group developed drug resistance, and the two therapies had good safety. Conclusion Both initial combination therapy with LAM and ADV and monotherapy with ETV produce a good clinical effect in HBeAg - positive CHB patients after 48 weeks of treatment. ALT normalization and HBV DNA clearance occur earlier in patients receiving ETV alone than those receiving LAM plus ADV. The two therapies have good safety, cause liitle drug resistance, and produce good treatment outcome and hold promise for clinical application. [ABSTRACT FROM AUTHOR]