Telbivudine alleviates liver dysfunction during antitubercular treatment in pulmonary tuberculosis patients with chronic HBV infections

Abstract

Objective To investigate the alleviation effect of telbivudine on liver dysfunction during antitubercular treatment in pulmonary tuberculosis patients with HBV DNA positive chronic HBV infection. Methods A total of 68 pulmonary tuberculosis patients with HBV DNA positive chronic HBV infection were enrolled from Huangpi People's Hospital during June 2011 and December 2013. Patients were randomly assigned to receive antitubercular plus telbivudine treatment (combination group, n=35) or antitubercular treatment only (single group, n=33). Chi-square and rank sum tests were performed to compare the incidence of liver damages, adjustment or termination of antitubercular treatment, and HBV reactivations between two groups. Results Liver damage was observed in 5 patients (5/35, 14.29%) of combination group and in 15 patients (15/33, 45.45%) of single group (χ2=7.95, P<0.05). One patient (1/35, 2.86%) in combination group adjusted the therapy, while 13 patients (13/33, 39.39%) in single group adjusted or terminated treatment (χ2=13.87, P<0.01). HBV reactivation occurred in 2 patients (2/35, 5.71%) of combination group, but in 10 patients (10/33, 30.30%) of single group (χ2=7.34, P<0.01). Conclusion Telbivudine can effectively alleviate liver dysfunction during antitubercular treatment in pulmonary tuberculosis patients with HBV DNA positive chronic HBV infections. Key words: Hepatitis B virus; Tuberculosis, pulmonary; Antitubercular agents; Drug-induced liver injury; Telbivudine