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Effect and Predictive Elements for 52 Weeks’ Telbivudine Treatment on Naïve HBeAg positive Chronic Hepatitis B

AUTHORS

Xiao-Feng Zhu 1 , Li-Xia Lu 2 , Ying Wang 3 , Kong-wen Xu 3 , Da-jiang Li 4 , Xia Zhu 5 , Li Liu 5 , Cong Liu 5 , Jin-Rong Wang 5 , Hong Tang 5 , Lichun Wang 4 , *

AUTHORS INFORMATION

1 Δepidemiology Department, West China School of public Health, Sichuan University, Chengdu, China

2 epidemiology Department, West China School of public Health, Sichuan University , Chengdu, China

3 epidemiology Department, West China School of public Health, Sichuan University , Chengdu, China.

4 Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China

5 Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.

ARTICLE INFORMATION

Hepatitis Monthly: 11 (12); e93029
Published Online: December 31, 2011
Article Type: Research Article
Received: May 06, 2019
Accepted: December 31, 2011
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Abstract

Background: Antiviral treatment with nucleoside analogs has been used for chronic hepatitis B (CHB). each kind of nucleoside analog has its own characteristics and suitability for patients. Telbivudine (LdT, brand name: Sebivo, Beijing novartis pharma Ltd) is the newest nucleoside analog, with strong and rapid viral suppression. However, its resistance rate is relatively high during long-term application, due to low genetic barriers to resistance. So, it is necessary to increase the effect and reduce resistance with effective management, according to baseline factors and early on-treatment responses. Objectives: To reveal possible predictive factors of the effect of telbivudine (LdT) treatment on naïve HBeAg-positive chronic hepatitis B (CHB) patients to optimize treatment. Patients and Methods: A total 71 naïve chronic hepatitis B (CHB) patients who met the inclusion criteria were enrolled. All patients were treated with LdT 600 mg Qd for at least 52 weeks. Multiple logistic regression analyses were done to investigate the predictive values of baseline factors and responses at Week 24. Results: The reduction in hepatitis virus B (HBV) DnA level was 6.44 ± 2.38 lg copies/mL at Week 52 compared with baseline. The complete virus response (CVR), biochemical response (BR), serological response (SR), and drug resistance (DR) were 61.99%, 77.46%, 35.21%, and 8.45% respectively. By multiple regression analysis, baseline alanine aminotransferase (ALT) levels significantly affected CVR (P = 0.024, oR = 1.008), and baseline ALT and baseline HBV DnA levels were independent compact factors of SR (P = 0.012, oR = 1.007; P = 0.001, oR = 0.423). The differences in CVR, SR, and DR in patients with ALT > 120 Iu/mL compared with patients with ALT ≤ 120 Iu/mL were statistically significant. The differences in SR in patients with HBV DnA > 107 copies/mL compared with patients with HBV DnA ≤ 107 copies/mL were statistically significant. Additionally, CVR, BR, and SR were differed significantly between patients with HBV DnA lower than 300 copies/mL at Week 24 and patients with HBV DnA higher than 300 copies/mL (P = 0.000, P = 0.0016, and P = 0.000, respectively). Conclusions: There were more responders among naïve HBeAg-positive chronic hepatitis B patients with lower HBV DnA levels (especially lower than 107 copies/mL) and higher ALT values (especially higher than 120 Iu/mL at baseline) to LdT treatment. Adjustments for treatment strategy should be considered if HBV DnA > 300 copies/mL at Week 24 is observed.

Keywords

Telbivudine Hepatitis B Chronic Predictive Value of Tests Alanine Transaminase Hepatitis B Virus

© 2011, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
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