Published online Jun 14, 2013. doi: 10.3748/wjg.v19.i22.3481
Revised: March 23, 2013
Accepted: March 28, 2013
Published online: June 14, 2013
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.