Comparison of telbivudine and entecavir in treatment of hepatitis B virus e antigen-positive chronic hepatitis B patients with high viral load

Abstract

Objective To compare the efficacy of telbivudine(LdT) and entecavir (ETV) in treatment of hepatitis B virus e antigen (HBeAg)-positive chronic hepatitis B (CHB) patients with high viral load (HBV DNA ≥ 107copies/mL).Methods Eighty-one HBeAg-positive CHB patients with high viral load were divided into LdT group (n=41) and ETV group (n=40).All patients received a 144-consecutive-week treatment.HBV DNA level,HBV serological markers,biochemical index,related complications,and drug resistance were observed and compared at the same time points between two groups.Results Baseline data of two groups were comparable.At 4,8 and 12 weeks,HBV DNA negative rates of LdT group were 24.4％,63.4％ and 80.5％,higher than 12.5％,27.5％ and 70.0％ of ETV group with significant differences (x2=5.102,P＜0.05); but no significant difference in HBV DNA negative rates at 144 weeks was noted between two groups (97.6％ vs 100.0％,x2=3.374,P＞0.05).After 144-week treatment,HBeAg seroconversion rate of LdT group was 63.4％,higher than 25.0％ of ETV group with a significant difference (x2=12.183,P＜0.01).In LdT group,2 cases (4.9％) had HBsAg seroconversion,5 cases (12.2％) developed drug resistance,and 8 cases (19.5％) had an elevation of creatine kinase.The total cost of LdT treatment was lower than that of ETV.Conclusions HBeAg-positive CHB patients with high viral load can obtain complete viral suppression after long-term (144 weeks) treatment with LdT or ETV.ETV has the advantage of low drug resistance and no adverse reaction,while LdT has higher rate of early viral suppression and seroconversion,and low cost. Key words: Hepatitis B, chronic; Telbivudine; Entecavir; High viral load; Long-term treatment