Telbivudine: an effective anti-HBV drug for chronic hepatitis B patients with early on-treatment responses.
BACKGROUND
Hepatitis B virus (HBV) is a significant hepatocarcinogen. HBV replication is a major cause for the development of hepatocellular carcinoma (HCC). Past studies have documented that lamivudine (LAM) therapy deterred progression to cirrhosis and HCC. This risk reduction is attributed to effective viral suppression. There is a need for as many effective anti-HBV drugs as possible.


METHODS
Telbivudine, the fourth FDA-approved oral antiviral drug, is highly potent for viral suppression for HBV. It is more potent than LAM and adefovir; its therapeutic response is superior to that of LAM in both HBeAg-positive and -negative patients, and it produces higher HBeAg seroconversion in patients with baseline ALT > or = 2 times normal. Telbivudine has a resistance rate lower than that of LAM and higher than that of entecavir or tenofovir.


RESULTS
There is a specific group of patients who are likely to achieve good therapeutic response with telbivudine.


CONCLUSIONS
Patients with low baseline HBV DNA combined with negative HBV DNA at week 24 obtain good therapeutic results with telbivudine. Therefore, selecting patients who meet the above conditions is important.
Hann
Hie-Won
HW
Liver Disease Prevention Center, Division of Gastroenterology and Hepatology, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA. Hie-Won.Hann@jefferson.edu
D000998:Antiviral Agents / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D024882:Drug Resistance, Viral; D006513:Hepatitis B e Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000187:drug effects / Q000235:genetics / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D006801:Humans; D009705:Nucleosides / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D011744:Pyrimidinones / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D000077712:Telbivudine; D013936:Thymidine / Q000031:analogs & derivatives; D013997:Time Factors; D016896:Treatment Outcome
D000998:Antiviral Agents; D006513:Hepatitis B e Antigens; D009705:Nucleosides; D011744:Pyrimidinones; D000077712:Telbivudine; D013936:Thymidine