Objective: To explore the influence of adefovir dipivoxil on HBV specific CTL in patients with chronic hepatitis B (CHB).

Methods: 10 mg adefovir dipivoxil (Zhengda Tianjing Pharmaceutical Company) was used for CHB patients with positive HBV DNA (HBV DNA > or = 1 x 10(4) copies/ml), ALT > 2 x upper limit of normal value (ULN) and positive human leucocyte antigen (HLA)-A2, orally, once a day for 3 months. Real time fluorescent quantitative PCR was used to determine HBV DNA and flowcytometer was used to determine HBV specific CTL.

Results: After treatment with adefovir dipivoxil for 3 months, HBV specific CTL (0.52 +/- 0.11)% was higher than that before treatment (0.34 +/- 0.14)%, t = 6.78 P < 0.01, HBV DNA of 28 cases turned to negative (<1 x 10(3) copies/ml) (62.22%). HBV DNA of 17 cases failed to turn negative 3 months after treatment, but their HBV DNA level was lower [(4. 18 +/- 0.4) log 10 copies/ml] than that before treatment [(6.23 +/- 0.73) log 10 copies/ml], t = 9.99, P < 0.01.

Conclusion: Adefovir dipivoxil can improve HBV specific cellular immunity in patients CHB.

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