Telbivudine in the treatment of patients with hepatitis B virus-related cirrhosis

Abstract:

Objective：To evaluate the clinical efficacy of telbivudine（LdT） in the treatment of patients with hepatitis B virus-related cirrhosis. Methods：A total of 43 patients with HBV DNA level more than 5 log10 copies/ml were enrolled in this study：23 patients received LdT 600 mg orally daily（LdT group） and 20 patients received no antiviral treatment（control group）. Liver function and serum HBV DNA level were assessed every 3 months. Results：The parameters of liver function（alanine aminotransferase（ALT），as－partate aminotransferase（AST），total bilirubin（TBIL），Child-pugh score）and serum HBV DNA level were significantly improved in LdT group compared with those in control group with the extension of the treatment（HBV DNA level was reduced to 4.83±0.70 at the 4th week；AST，TBIL and Child-pugh score were reduced to （55.19±22.48） U/L，（36.81±22.11） μmol/L，6.65±1.94 respec－tively at the 12th week；ALT was reduced to （63.67±19.52） U/L at the 24th week）（P<0.05）. The serum ALB level showed no remarkable change in LdT group than in control group. Two patients in LdT group experienced virological breakthrough after 24 and 36 weeks（rtM204 mutations） and were salvaged treat－ment with adefovir dipivoxil. Conclusion：LdT suppresses viral replication and improves liver function in patients with chronic hepatitis B cirrhosis，but there is still a risk of emergence of LdT resistance.