Abstract: Obiective To analyze the efficacy and the predictive factors of peginterferon α-2a （PEG-IFNα-2a） and adefovir dipivoxil （ADV） combination therapy in patients with HBeAg-positive chronic hepatitis B （CHB）. Methods 196 CHB patients positive for HBeAg were divided into PEG-IFNα-2a monotherapy group （n=64），ADV monotherapy group（n=66），and PEG-IFNα-2a plus ADV combination therapy group （n=66）. All patients were treated for 48 weeks. Serum INF-γ and IL-10 levels were detected by ELISA. Results At the end of 48 weeks，the serum HBV DNA loss，HBeAg negative，HBeAg seroconversion and ALT normalization rates in PEG-IFNα-2a plus ADV group（74.2%，24.2%，48.5% and 80.3%） were significantly higher than in ADV group （62.1%，13.6%，9.1% and 65.2%，P<0.05） and in PEG-IFNα-2a group（53.1%，10.9%，29.7% and 54.7%，P<0.05）； Serum INF-γ levels in combined treatment group [（45.3±11.3） pg/ml] were significantly higher than in ADV group [（36.3±11.5） pg/ml，P<0.05] and in PEG-IFNα-2a group [（37.1±10.3） pg/ml，P<0.05]；Serum IL-10 levels in combined treatment group [（10.3±14.6） pg/ml] were significantly lower than in ADV group [（18.3±10.5） pg/ml，P<0.05] and in PEG-IFNα-2a group [（17.1±11.3） pg/ml，P<0.05]；Serum HBeAg seroconversion rate in combined treatment group at the end of 48 weeks was associated with the negative rate of HBeAg at 24 weeks，e.g. greater than 89.1% reduction of serum HBeAg levels at 24 weeks than baseline had a positive predictive value of 88.7%，negative predictive value of 81.9%，sensitivity of 83.1% and specificity of 87.9%. Conclusion The efficacy of pegylated interferon α-2a combination with adefovir dipivoxil therapy is superior to monotherapy of either of them in HBeAg-positive chronic hepatitis B patients and the reduction of HBeAg levels at 24 weeks could predict the efficacy of 48 weeks.

Key words: Chronic hepatitis B, Adefovir dipivoxil, Peginterferonα-2a, Efficacy, Prediction