Antivirus/Immunomodulatory Therapy Induce CccDNA Decline In Chronic Hepatitis B Patients With HBeAg Positive And Treatment-na(?)ve

Aim:To investigate the efficacy of Antivius/immunomodulatory therapy for 48 weeks in chronic hepatitis B(CHB) patients with positive hepatitis B e antigen(HBeAg) titer adefovir dipivoxil(ADV).Methods:This was a randomized, open and prospective clinical trial. Divide 90 CHB patients into three groups (Ⅰ:IFN-α2b; Ⅱ:IFN-α2b+ADV; Ⅲ: IFN-α2b+ADV+GM-CSF+HB vaccine). After the treatment, efficacy of three therapies were assessed by comparing the HBeAg loss rate, HBV DNA loss rate and reduction of HBV covalent closed circular DNA(cccDNA).Results:The reduction means of intrahepatic cccDNA:Ⅰ:(1.22±1.56) lg copies/mL; Ⅱ: (2.06±1.33)lg copies/mL; Ⅲ:(3.26±1.31)lg copies/mL(between each other, P<0.05). The HBeAg loss rate:Ⅰ:22.2%; Ⅱ:27.6%; Ⅲ:34.5% (between each other, P>0.05). The HBV DNA loss rate:Ⅰ:51.9%、Ⅱ:79.3%, Ⅲ:82.8%(Ⅰ to Ⅱor Ⅲ:P<0.05, Ⅱ to Ⅲ:P>0.05).Conclusion:Compared IFN-α2b monotherapy and combination therapy with IFN-α2b plus ADV, the combination therapy of IFN-α2b and ADV and GM-CSF and HB vaccine can induce a strong cccDNA decline.