title: Comparison of the efficacy of lamivudine and telbivudine in the treatment of chronic hepatitis B: a systematic review.
abstract: BACKGROUND
  Chronic viral hepatitis B remains a global public health concern. Currently, several drugs, such as lamivudine and telbivudine, are recommended for treatment of patients with chronic hepatitis B. However, there are no conclusive results on the comparison of the efficacy of lamivudine (LAM) and telbivudine (LdT) in the treatment of chronic hepatitis B.
  
  
  RESULTS
  To evaluate the comparison of the efficacy of LAM and LdT in the treatment of chronic hepatitis B by a systematic review and meta-analysis of clinical trials, we searched PUBMED (from 1990 to April 2010), Web of Science (from 1990 to April 2010), EMBASE (from 1990 to April 2010), CNKI (National Knowledge Infrastructure) (from 1990 to April 2010), VIP database (from 1990 to April 2010), WANFANG database (from 1990 to April 2010), the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Review. At the end of one-year treatment, LdT was better than LAM at the biochemical response, virological response, HBeAg loss, therapeutic response, while less than at the viral breakthrough and viral resistance, but there was no significant difference in the HBeAg seroconversion and HBsAg response. LdT was better than LAM at the HBeAg seroconversion with prolonged treatment to two years.
  
  
  CONCLUSIONS
  In summary, LdT was superior in inhibiting HBV replication and preventing drug resistance as compared to LAM for CHB patients. But LdT may cause more nonspecific adverse events and can lead to more CK elevation than LAM. It is thus recommended that the LdT could be used as an option for patients but adverse events, for example CK elevation, must be monitored.
authors.affiliation: Department of Infectious Diseases, Xiangya Hospital, Central South University, Changsha, China. zhaoshuiquan@gmail.com
authors.forename: Shushan
authors.initials: S
authors.lastname: Zhao
authors.forename: Lanhua
authors.initials: L
authors.lastname: Tang
authors.forename: Xuegong
authors.initials: X
authors.lastname: Fan
authors.forename: Lizhang
authors.initials: L
authors.lastname: Chen
authors.forename: Rongrong
authors.initials: R
authors.lastname: Zhou
authors.forename: Xiahong
authors.initials: X
authors.lastname: Dai
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D016208:Databases, Factual; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D009705:Nucleosides / Q000627:therapeutic use*; D011744:Pyrimidinones / Q000627:therapeutic use*; D000077712:Telbivudine; D013936:Thymidine / Q000031:analogs & derivatives; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D009705:Nucleosides; D011744:Pyrimidinones; D000077712:Telbivudine; D019259:Lamivudine; D013936:Thymidine
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