title: Comparison of clinical efficacy and renal safety of telbivudine and entecavir in chronic hepatitis B patients receiving cytotoxic chemotherapy.
abstract: OBJECTIVE
  Limited data is available on the clinical outcomes of telbivudine (LdT) and entecavir (ETV) in pre-emptive antiviral chemoprophylaxis. This study aimed to evaluate the clinical efficacy and renal safety of LdT and ETV in patients with chronic hepatitis B (CHB) who received cytotoxic chemotherapy.
  
  
  METHODS
  Altogether 290 treatment-naïve CHB patients undergoing intense chemotherapy were enrolled to receive daily 600 mg of LdT or 0.5 mg of ETV as pre-emptive antiviral chemoprophylaxis.
  
  
  RESULTS
  The ETV group had significantly higher proportion of patients with undetectable hepatitis B viral (HBV) DNA load compared with LdT at week 24 (73.0% vs 50.3%, P = 0.000). The cumulative rates of virological breakthrough in the LdT and ETV groups were 9.15% and 3.65% at the second year of therapy, respectively (P = 0.059), which was associated with detectable HBV DNA at week 24 (P = 0.000). The MELD score of the LdT group was significantly lower than that of the ETV group after the first year (4.53 vs 7.53, P = 0.002) and the second year (1.96 vs 7.09, P = 0.000) of antiviral therapy. Moreover, the estimated glomerular filtration rate (eGFR) was significantly improved in the LdT group than in the ETV group after two years of antiviral therapy.
  
  
  CONCLUSIONS
  LdT has a lower clinical efficacy in viral suppression than ETV, but LdT is associated with greater extent of improvement in liver and renal functions of patients in pre-emptive prophylaxis for cytotoxic chemotherapy.
authors.affiliation: Departments of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong SAR, China.
authors.forename: Siu-Tong
authors.initials: ST
authors.lastname: Law
authors.affiliation: Departments of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong SAR, China.
authors.forename: Ming Kai
authors.initials: MK
authors.lastname: Lee
authors.affiliation: Department of Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong, SAR, China.
authors.forename: Ann Shing
authors.initials: AS
authors.lastname: Lee
authors.affiliation: Department of Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong, SAR, China.
authors.forename: Yuk
authors.initials: Y
authors.lastname: Tung
authors.affiliation: Departments of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong SAR, China.
authors.forename: Kin Kong
authors.initials: KK
authors.lastname: Li
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006147:Guanine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000235:genetics / Q000502:physiology; D019694:Hepatitis B, Chronic / Q000517:prevention & control* / Q000821:virology; D006801:Humans; D007668:Kidney / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D012189:Retrospective Studies; D055502:Secondary Prevention / Q000379:methods*; D000077712:Telbivudine; D013936:Thymidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014775:Virus Activation / Q000187:drug effects
chemical_list: D000970:Antineoplastic Agents; D000998:Antiviral Agents; D004279:DNA, Viral; D000077712:Telbivudine; C413685:entecavir; D006147:Guanine; D013936:Thymidine
keywords: chronic hepatitis B; entecavir; glomerular filtration rate; pre-emptive prophylaxis; telbivudine