Abstract: Objective To investigate the efficacy and safety of adefovir dipivoxil （ADV）alone or in combination with lamivudine （LAM） in the treatment of patients with LAM-resistant hepatitis B e antigen（HBeAg）-positive chronic hepatitis B （CHB）. Methods One hundred patients with LAM-resistant HBeAg-positive CHB were randomly divided into ADV treatment group （n=50） and combinational therapy group （LAM plus ADV，n=50）; The treatment was carried on for 12 m；At the end of 3，6，9 and 12 m，the normalization rate of ALT，serum HBV DNA viral load， seroconversion rate of HBeAg，and adverse events were observed. Results At the end of 3，6，9 and 12 m of treatment，serum HBV DNA load in patients receiving ADV alone or in combinational therapy decreased significantly as compared to their baselines levels（P＜0.05）；Furthermore，at the end of 6，9 and 12 m，serum HBV DNA load in combinational therapy patients were lower than those in patients receiving ADV alone [（3.94±1.16），（3.37±1.19） and（3.14±1.18） lg copies/ml vs.（4.51±1.37），（4.07±1.14） and （3.85±1.16）lg copies/ml，respectively，P<0.05]；At the end of 6，9 and 12 m of treatment，the negative conversion rates of serum HBV DNA in combinational group were 56.0%，64.0% and 76.0%，respectively，significantly higher than those in patients receiving ADV alone （32.0%，44.0%，and 56.0%，respectively，P<0.05），while the normalization rates of ALT in combinational group were 72.0%，80.0%，and 92.0%，respectively，significantly higher than those in patients with ADV treatment alone（52.0%，60.0%，and 76.0%，respectively，P<0.05）；There was no significant difference in negative conversion rates of HBeAg or seroconversion rate of HBeAg to anti-HBe between the two groups；Serious adverse events did not occur in both groups. Conclusions ADV in combination with LAM in treatment of patients with LAM-resistant HBeAg-positive CHB is effective and safe and is promising in dealing with nucleos（t）ide-resistant patients with CHB.

Key words: Hepatitis B, Adefovir dipivoxil, Lamivudine, Hepatitis B e antigen-positive, Efficacy