Clinical observation of telbivudine in treatment of patients with HBeAg positive chronic hepatitis B

JIN Rui; CHEN Xin-yue; ZHANG Hong-fei; GUO Xin-hui; LI Xiu-hui; DING Hui-guo; ZHAO Guo-qing; CHEN Xiao; TONG Li-xin

doi:10.3760/cma.j.issn.1673-4777.2012.09.023

Abstract：Objective To observe the clinical efficacy and safety of telbivudine in treating HBeAg-positive chronic hepatitis B. Methods Totally 210 cases of outpatients with HBeAg-positive chronic hepatitis B were divided into two groups;104 cases of them were treated with telbivudine (600 mg/d)and 106 cases of them were treated with lamivudine (100 mg/d)for 52 weeks.Serum HBV DNA,the serum HBV markers and biochemical indicators of the liver were observed.We also observed the factors that may influence the curative effect on the 12nd week and the 24th week. Results After 52 weeks of treatment,serum HBV DNA undetectable rate,HBeAg negative conversion rate,HBeAg conversion rate,the ALT normalization rates,viral breakthrough rates and virological rebound rate were superior to those lamivudine with telbivudine. The differences were statistically significant [ 70.2％ (73/104)vs 56.6％ (60/106 );35.6％ (37/104 )vs 12.3％ (13/106 );22.1％ (23/104 )vs 11.3％ (12/106 );77.9％ (81/104 )vs 55.7％ (59/106 );6.7％ (7/104 )vs 16.0％ (17/106 );2.9％ (3/104 )vs 10.4％ (11/106);P ＜0.01 or P＜0.05 ].After 24 weeks of treatment with telbivudine,the patients with HBV DNA below 500 copies/ml showed better HBV DNA undetectability rate and viral rebound rate at the 52nd week than those with HBV DNA above 500 copies/ml. The difference was significant (P＜0.05 ). Conclusion Telbivudine in treatment of HBeAg-positive chronic hepatitis B is superior to lamivudine,can rapidly and sustainly suppress HBV replication,HBeAg conversion,make liver function return to normal,has few adverse events,good patient' tolerance,can long-term treat chronic hepatitis B.