Abstract: Objective To observe the efficacy and safety of adefovir dipivoxil (ADV) anti-HBV treatment when the dose increased to 15 mg/d from 10 mg/d when the response is poor. Methods Total of 45 patients were treated with ADV was 10 mg/d conventionally. Factors such as resistance and poor compliance to ADV were excluded, the dose of patients with poor response to ADV 10 mg/d was increased to 15 mg/d and the changes of HBV DNA, liver function, kidney function and myocardial enzymes were observed. Results After the dose was increased by 50%, HBV DNA levels reduced to an average of 2.5 log 10 copies/ml, no significant difference was found in ALT and AST. Serum urea nitrogen (BUN) and creatinine (Cr) increased in 11 patients, which were still within the normal range. However, 5 patients discontinued the treatment due to abnormal serum BUN and Cr. Conclusions For patients with poor antiviral response of ADV 10 mg/d, the dose of ADV could increase to 15 mg/d with safe and reliable effect.