Abstract: Objective The aim of this study was to investigate the short-term efficacy of adefovir dipivoxil (ADV) and entecavir (ETV) or tenofovir (TDF) combination rescued therapy in patients with chronic hepatitis B and rtA181V/T mutation. Methods Fifty patients with CHB and rtA181V/T mutation were admitted to the Department of Infectious Diseases in our hospital between January 2017 and January 2020, and were divided randomly into two groups, receiving ADV and TDF or ADV and ETV treatment, with 25 cases in each. Serum HBV DNA loads was assayed by real-time fluorescent quantitative PCR. Serum β2-microglobulin (β2-MG), retinol-binding protein (RBP) and serum creatinine (sCr) were detected, and creatinine clearance (Crcl) and estimaated glomerular filtration rate (eGFR) were calculated. Peripheral blood T lymphocytes were performed by flow cytometry. Results At the end of 24-week and 48-week, serum HBV DNA negative rate in patients receiving ADV and TDF combination treatment were 100.0% and 100.0%, not significantly different compared to 96.0% and 96.0%, respectively, in ADV and ETV combination-treated patients (P>0.05); serum AST levels were (49.2±5.5)U/L and (30.4±4.0)U/L, significantly lower than [(55.3±7.0) U/L and (43.2±6.8) U/L, respectively, P<0.05], serum ALT levels were (40.3±6.1) U/L and (39.1±4.3) U/L, significantly lower than [(65.1±7.5)U/L and (45.3±6.1)U/L,P<0.05], and serum HBV DNA loads were (0.8±0.2)lg IU/mL and (2.0±0.4)lg IU/mL, significantly lower than [(2.9±0.3)lg IU/mL and (1.2±0.2) lg IU/mL, respectively, P<0.05] in ADV and ETV combination-treated patients; the percentages of peripheral blood CD4⁺ cells were(45.2±3.6)% and (48.3±4.2)%, and the ratios of CD4⁺/CD8⁺ cells were (1.4±0.2) and (1.8±0.1), significantly higher than [(42.4±3.1)% and (45.0±3.2)%, and (1.2±0.1)and (1.5±0.1), respectively, P<0.05] in ADV and ETV combination-treated patients; there was no significant changes of renal function tests in the two groups. Conclusion The short-term efficacy of ADV and TDF combination therapy in patients with CHB and rtA181V/T mutation is good, with the rapid inhibition of viral replication and stable liver function tests without side effects.

Key words: Hepatitis B, rtA181V/T mutation, Tenofovir, Entecavir, Adefovir dipivoxil, Rescued therapy