The Clinical Research Of Serum CccDNA In Treat Ment Of Adefovir Dipivoxil To The Chronic Hepatitis B

Objective To investigate the clinical value of serum cccDNA in treatment of Adefovir Dipivoxil to the Chronic Hepatitis B.Methods Eighty-one patients with Chronic Hepatitis B was internalized by the standard condition, which received Adefovir Dipivoxil (ADV) treatment by taking one to 10mg daily. These patients were divided into cccDNA positive and negative groups by detecting serum cccDNA. HBVDNA, HBeAg, HBe-Ab and ALT were detected in all patient serum before ADV treatment and till ADV treatment week 24,48,72 and 96.Results Two groups were not significantly different in age and gender (P>0.05). Spearman rank correlation between serum cccDNA and HBVDNA, HBeAg and ALT were 0.756,0.647 and 0.550 respectively before ADV treatment, therefore, serum cccDNA is positively correlated with those virological and biochemical parametes. Two groups were not significantly different in negative rate of HBVDN A,e-system seroconversion and normalization rate of ALT at week 24 and 48 (P> 0.05). They were significantly different in negative rate of HBVDNA and e-system seroconversion at week 72 (P<0.05), except normalization rate of ALT (P>0.05). They were significantly different in negative rate of HBVDNA (34.14%vs59.46%, x2=5.014),negative rate of HBeAg (21.95%vs 48.64%, x2=6.125) positive rate of HBe-Ab (19.51%vs40.54%, x 2=4.136) and normalization rate of ALT (87.80%vs100.00%x2=2.370) at ADV treatment week 96 (P<0.05). Median of HBVDNA had decreased gradually, especially cccDNA negative group, with prolongation of the treatment. Two groups was significantly different in decrease of HBeAg at week 48,72 and 96 (P<0.05). except baseline and week 24 (P>0.05). Two groups was not significantly different in decrease of ALT at baseline and week 24 and 48 (P>0.05), except week 72 and 96 (P<0.05).Therefore,with prolongation of treatment, response of cccDNA negative group was higher obviously than cccDNA negative group in virology, serology and biochemistry.Conclusion With prolonging treatment, ADV is effective in clearance of HBVDNA and decrease of HBeAg and ALT, cccDNA negative group decreased faster than cccDNA postive group. Therefore serum cccDNA is predictive value as ADV treatment to Chronic Hepatitis B.