| Objective To explore the changes of peripheral blood cells in HBeAg positive chronic hepatitis B (CHB) patients treated with pegylated interferon alpha-2b or combined with adefovirdipivoxil (ADV) via a randomized, open-label and multicenter clinical study. Methods Between June 2012 and September 2013, 102 HBeAg positive CHB cases from 10 hospitals of Anhui province, such as the First Affiliated Hospital of Anhui Medical University, Affiliated Chaohu Hospital of Anhui Medical University, the First Affiliated Hospital of Anhui University of Chinese Medicine, the Second People's Hospital of Fuyang City, Affiliated Yijishan Hospital of Wangnan Medical College and so on, were recruited and randomly divided into pegylated interferon alpha-2b monotherapy group and pegylated interferon alpha-2b combined with ADV therapy group. All patients provided written informed consent before enrolling in the study. The study consisted of 48 weeks of treatment and a 24-week follow-up period after end-of-treatment. The changes in peripheral bloodcells at baseline (0 weeks), 4 weeks, 8 weeks, 12 weeks, 24 weeks, 36 weeks, 48 weeks, 60 weeks and 72 weeks of each group were inspected to compare the effects of two treatment regimens. Results At the 48 weeks of treatment, the negative conversion rate of HBV DNA (76.60%) and the ALT recurrence rate (70.21%) in the combination group were significantly higher than those in the monotherapy group, and the difference was statistically significant (P<0.05). White blood cells (WBC), neutrophils (N), lymphocyte (L), red blood cells (RBC), hemoglobin (Hb) and platelet (PLT) levels were different at different time points, and the difference was statistically significant (P<0.05). There were interactions between Hb levels, PLT levels and groups, and the difference was statistically significant (P<0.05). The influence of the monotherapy group on neutrophils was greater than that of the combination group, and the difference was statistically significant (P<0.05). WBC, N, L and PLT levels of each group were reduced in varying degrees, especially at the first 0~4 weeks, then turned to be stable during the treatment and returned to normal after end-of-treatment. Conclusion Combination therapy has some advantages. There are similar down regulations of peripheral blood cells, including WBC, N, L and RBC, in patients between two groups during the therapy. However, combination therapy has reversible impacts on Hb and PLT levels which recover quickly after end-of-treatment, indicating the necessity of close monitoring during therapy. |
