Brief Article
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World J Gastroenterol. Jun 14, 2013; 19(22): 3481-3486
Published online Jun 14, 2013. doi: 10.3748/wjg.v19.i22.3481
Efficacy of combined therapy in patients with hepatitis B virus-related decompensated cirrhosis
Guo-Cai Lv, Jin-Mei Yao, Yi-Da Yang, Lin Zheng, Ji-Fang Sheng, Yu Chen, Lan-Juan Li
Guo-Cai Lv, Jin-Mei Yao, Yi-Da Yang, Lin Zheng, Ji-Fang Sheng, Yu Chen, Lan-Juan Li, Clinical Laboratory, First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Lan-Juan Li, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Lv GC, Yao JM performed the majority of experiments; Sheng JF and Zheng L provided analytical tools and were involved in revising the manuscript; Li LJ and Chen Y designed the study; Yang YD wrote the manuscript.
Supported by The China National Science and Technology Major Project, No. 2010ZB063; Health Department of Zhejiang Province, China, No. 2010KYA067
Correspondence to: Lan-Juan Li, MD, PhD, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital of Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. ljli@mail.hz.zj.cn
Telephone: +86-571-87236755 Fax: +86-571-87236755
Received: November 17, 2012
Revised: March 23, 2013
Accepted: March 28, 2013
Published online: June 14, 2013
Core Tip

Core tip: Present treatment guidelines advocate oral nucleos(t)ide analogues in decompensated chronic hepatitis B (CHB) patients. Studies with lamivudine (LAM) have demonstrated decreased mortality and improved liver function in CHB decompensated patients. However, LAM resistance mutations emerging during monotherapy can negate therapeutic benefit. Adefovir dipivoxil had no cross resistance with LAM. Consistent with outcomes in patients with LAM-resistance, no patient in de novo combination therapy group showed detectable resistance up to 144 wk in this study. The de novo combination therapy markedly improved liver function, reduced Child-Turcotte Pugh and Model for End-Stage Liver Disease scores in hepatitis B virus-related decompensated cirrhosis patients.