Analysis Of Related Factors Of Poor Response To Adefovir Dipivoxil In The Treatment Of Chronic

Objective To investigate the factors of poor virological response to Adforvir Dipivoxil(ADV) treatment in patients with choronic hepatitis B. Methods 80 patients on the initial treatment for chronic HBV infection were selected randomly.The ALT,AST,HBV DNA,HBsAg,HBeAg,ALB,PTA and DNA mutations were recorded at baseline.And the ALT,AST,HBV DNA,HBsAg,HBeAg were recorded after the ADV therapy 4,12,24 weeks. According to the treatment at 24 weeks HBV DNA load, divided into complete response group(HBV DNA<the lowest detection limit) and partial response group(HBV >2log10 copies/ml,but still more than the minimum detection limit). Results There were no apparently relationship between age,sex,ALB,PTA,ALT,AST with the poor virological response(P>0.05). The BMI,HBV DNA,HBsAg when HBeAg was positive and the BMI,HBV DNA when HBe Ag was negative were negatively correlated with the response(P<0.05). There were significant statistical differences in V of 181 mutations(≥5%) and T of 236 mutations(≥5%) when HBeAg was positive(P<0.05). There was significant statistical difference in T of 236 mutations(≥5%) when HBeAg was negative(P<0.05). But there was no obvious statistical difference in V of 181 mutations(<5%) when HBeAg was negative(P>0.05). The HBVDNA of 12 weeks and 24 weeks which were(1.326±0.907)log10copies/ml and(1.279±1.156)log10copies/ml lower than the basic level were easy to the poor virological response(P<0.05) in the HBeAg positive patients. The HBVDNA of 12 weeks and 24 weeks which were lower(0.983±0.706)log10copies/ml and(1.178±0.736)log10copies/ml than the basic level were easy to the poor virological response(P<0.05) in the HBeAg negative patients. There were no obvious relationships between the changes of ALT、AST、the fourth weeks HBVDNA and the response(P>0.05). E antigen positive group with poor response ratio was 76.09%, compared with E antigen negative group(38.24%) was significantly higher,so E antigen positive was more likely to cause poor response(P<0.05). There were no obvious relationships between the changes of 4 weeks and 12 weeks and the response(P>0.05)in the HBeAg positive patients.The HBeAg of 24 weeks which was( 108±76) S/CO lower than the basic level was easy to the poor virological response(P<0.05) in the HBeAg positive patients. Conclusion There were no apparently relationship between age,sex,ALB,PTA,ALT,AST with the poor virological response.The high level of BMI,HBV DNA,HBsAg,HBe Ag positive,V(≥5%)mutations of 181,T(≥5%)mutations of 236(HBeAg positive) and T(≥5%)mutations of 236(HBeAg negative) were the influcing factors on poor virological response with ADV treatment for 24 weeks. The HBVDNA of 12 weeks and 24 weeks which was(1.326±0.907)log10copies/ml and(1.279±1.156)log10copies/ml lower than the basic level was easy to the poor virological response in the HBeAg positive patients. The HBVDNA of 12 weeks and 24 weeks which was lower( 0.983±0.706) log10copies/ml and(1.178±0.736)log10copies/ml than the basic level was easy to the poor virological response in the HBeAg negative patients.There were no obvious relationships between the changes of ALT、AST、the fourth weeks HBVDNA and the response. There were no obvious relationships between the changes of 4、12 weeks and the response in the HBeAg positive patients.The HBeAg of 24 weeks which was(108±76)S/CO lower than the basic level was easy to the poor virological response in the HBeAg positive patients.