Objective   To investigate the early response to adefovir dipivoxil (ADV) and entecavir (ETV) combination therapy in patients with chronic hepatitis B (CHB)

who have underwent multi-nucleoside/nucleotide analogues (NAs)

and to analyze the risk factors influencing the therapeutic effects.    Methods   There were 51 patients who experienced failure of multi-NAs sequential treatment and finally r

eceived ADV (10 mg

oral taking

once per day)+ETV (0.5 mg

oral taking

once per day) combination therapy. Clinical features were collected. Alanine aminotransferase (ALT) level

HBeAg status

hepatitis B virus (HBV) DNA level

HBV genotype and NAs-resistant mutation were detected. Eleven potential risk factors for the early response to ADV+ETV treatment were analyzed by Binary logistic regression.    Results   Thirty-nine of the 51 patients receiving ADV+ETV therapy obtained the early response (with their HBV DNA level was decreased to 1×10

3

copies/ml or undetectable after 6 months’ treatment). The early response rate was 76.5%. The logistic regression showed that there were 2 factors

baseline ALT level (P=0.028

OR=1.021

95%CI: 1.002 to 1.039) and duration of undergoing NAs sequential treatment prior to combination therapy (P=0.029

OR=0.945

95%CI: 0.898 to 0.994) of statistical significance.    Conclusion   ADV+ETV therapy is effective rescue strategy in patients who experienced failure of multi-NAs sequential treatment. Those patients with higher baseline ALT level and shorter duration of undergoing sequential antiviral drugs before combination therapy with ADV+ETV are easier to obtain the early response to successive ADV+ETV.