ORIGINAL ARTICLE   

Minerva Medica 2017 December;108(6):507-12

DOI: 10.23736/S0026-4806.17.05222-3

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Effects of the combined administration of entecavir and adefovir dipivoxil to improve hepatic fibrosis in hepatitis B patients with interferon resistance

Yuqiu SUN ¹, Keqin WU ¹, Fei SHEN ¹, Ling QIU ¹, Binhe CHEN ², Lijun YU ³, Shuzhen CHANG ¹ ✉

¹ Department of Liver Disease, Jinan Hospital of Infectious Diseases, Shandong University, Jinan, China; ² Shandong Academy of Pharmaceutical Science, Jinan, China; ³ Department of Liver Disease, Qianfoshan Hospital of Shandong Province, Jinan, China

BACKGROUND: To observe the effect of the combined administration of entecavir and adefovir dipivoxil to improve hepatic fibrosis in hepatitis B patients with interferon resistance.
METHODS: This study comprised 90 hepatitis B patients with hepatic fibrosis and interferon (IFN) resistance who were admitted in the hospital’s department of infectious disease for diagnosis and treatment between January 2013 and September 2015. They were randomly divided into two groups in accordance with the random number table: the combination treatment group (N.=45) and the entecavir group (N.=45). They were observed for any variations in the indexes of liver function and fibrosis, as well as the Model for end-stage liver disease (MELD) scores, before and after treatment.
RESULTS: After treatment, the levels of the indexes in both groups (the combination treatment group vs. the entecavir group) were as follows: bilirubin (67.5±7.7 vs. 82.4±13.5 μmol/L); International Normalized Ratio (INR) (1.21±0.8 vs. 1.14±0.7); creatinine (147.3±12.4 vs. 287.4±21.6 mg/dL); GGT (67.4±23.2 vs. 88.4±23.7 U/L); and ALT (63.4±40.8 vs. 96.5±23.5 U/L). In comparison of the indexes of hepatic fibrosis between the two groups, we found the following differences: PCIII (67.5±7.7 vs. 82.4±13.5 μg/L); IV-C (61.3±18.7 vs. 74.5±17.9 μg/L); HA (147.3±12.4 vs. 87.4±31.6 μg/L); and LN (88.7±13.2 vs 102.5±23.4 μg/L). The results showed that the differences in comparison of the indexes before and after the treatment were statistically significant (P<0.05). After treatment, the MELD score of patients in the combination treatment group was significantly lower than that in the entecavir group (18.7±3.2 vs. 22.5±3.4), with a statistically significant difference (P<0.05).
CONCLUSIONS: In the chronic hepatitis B patients with interferon resistance, the combined administration of entecavir and adefovir dipivoxil can significantly improve liver function, hepatic fibrosis and MELD scores. The results highlight the need to promote the benefits of this drug combination in helping chronic hepatitis B patients with interferon resistance, and to promote its application in clinical practices.

KEY WORDS: Hepatitis B - Liver cirrhosis - Interferons