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Efficacy of telbivudine treatment for hepatitis B e antigen‐positive chronic hepatitis B patients with poor response to adefovir dipivoxil
Author(s) -
Li Y.,
Zhang Y.,
Wang J.P.,
Lian J.Q.,
Bai X.F.
Publication year - 2013
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12063
Subject(s) - telbivudine , adefovir , medicine , seroconversion , hbeag , chronic hepatitis , hepatitis b , adverse effect , gastroenterology , viral load , virology , hepatitis b virus , immunology , lamivudine , virus , hbsag
Summary Telbivudine ( LdT ) has demonstrated potent antiviral activity in nucleos(t)ide analogue ( NA )‐naïve chronic hepatitis B patients ( CHB ), but data on its efficacy in NA ‐experienced patients are limited. The aim of this study was to investigate the effect of LdT in hepatitis B e antigen‐positive CHB patients with poor response to initial adefovir dipivoxil ( ADV ). Forty‐two CHB patients with HBV DNA > 4 log 10 copies/mL after 12 months of ADV monotherapy were enroled in the study and thereafter treated with LdT 600 mg daily for 18 months. Telbivudine led to a rapid decrease in viral load, and viral replication was persistently suppressed with a reduction of 2.26 log 10 copies/mL 18 months after LdT treatment. The rates corresponding to virological and biochemical response at the end of observation were 97.6% (41/42) and 65.8% (25/38), respectively. HBeAg loss was found in 30.8% (12/39) of patients, while HB e A g/anti‐ HB e seroconversion was found in 17.9% (7/39). Only one patient was detected to have LdT ‐associated mutation, and no severe adverse events were reported. Optimization therapy with LdT monotherapy may be a good choice for CHB patients with poor response to ADV , and switching to LdT may be the most cost‐effective rescue therapeutic strategy for patients with poor response to initial ADV monotherapy.