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Comparison of telbivudine efficacy in treatment-naive patients with hepatitis B virus-related compensated and decompensated cirrhosis in 96 weeks.

AbstractOBJECTIVE:
Data are limited for comparison of the long-term efficacy of telbivudine (LdT) between hepatitis B virus (HBV)-related compensated and decompensated cirrhosis. The aim of this study was to compare the efficacy of LdT in treatment-naive patients with HBV-related compensated and decompensated cirrhosis in 96 weeks.
PATIENTS AND METHODS:
We reviewed the data of 65 compensated and 62 decompensated cirrhotic patients treated with LdT for 96 weeks, and compared the difference in the related indicators before and after treatment between the groups.
RESULTS:
Alanine aminotransferase normalized rate was significantly higher in the compensated group than in the decompensated group at weeks 12 and 24 (67.7 vs. 40.3% and 78.5 vs. 53.2%, respectively, P<0.01). Albumin level was much higher than the baseline at week 24 in the compensated group (35.1±6.2 vs. 39.9±5.1, P<0.01), but significance was observed from week 48 onwards in the decompensated group (29.8±3.7 vs. 33.7±3.8, P<0.05). The Child-Turcotte-Puge score either improved or remained steady in both groups. The HBV DNA negativity rate at week 12 (56.9 vs. 32.3%, P<0.01) was higher, whereas the drug resistance rate was lower (P>0.05), in the compensated group than in the decompensated group. The degree of esophageal varix was alleviated, including 11 (16.9%) compensated and four (6.5%) decompensated cirrhotic patients. Liver stiffness was significantly decreased in the compensated group compared with the baseline [19.1 (7.3-32.6) vs. 14.8 (7.4-32.5), P<0.01]; however, there was no statistical significance in the decompensated group compared with the baseline [30.5 (9.1-55.0) vs. 29.9 (8.4-53.2), P>0.05].
CONCLUSION:
Long-term LdT treatment showed superior virological, biochemical, and clinical efficacy in the compensated cirrhotic patients. Therefore, we emphasized the importance of early antiviral treatment, which may improve the prognosis of cirrhotic patients.
AuthorsXiaoling Yang, Jia Li, Li Zhou, Junjuan Liu, Jinghan Wang, Wei Lu
JournalEuropean journal of gastroenterology & hepatology (Eur J Gastroenterol Hepatol) Vol. 26 Issue 4 Pg. 396-403 (Apr 2014) ISSN: 1473-5687 [Electronic] England
PMID24569820 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • ALB protein, human
  • Antiviral Agents
  • Biomarkers
  • Serum Albumin
  • Telbivudine
  • Alanine Transaminase
  • Cholinesterases
  • Thymidine
  • Serum Albumin, Human
Topics
  • Adult
  • Alanine Transaminase (blood)
  • Antiviral Agents (adverse effects, therapeutic use)
  • Biomarkers (blood)
  • Cholinesterases (blood)
  • Drug Resistance, Viral
  • Esophageal and Gastric Varices (virology)
  • Female
  • Hepatitis B (blood, complications, diagnosis, drug therapy)
  • Humans
  • Liver (drug effects, pathology, virology)
  • Liver Cirrhosis (blood, diagnosis, drug therapy, virology)
  • Male
  • Middle Aged
  • Retrospective Studies
  • Serum Albumin (metabolism)
  • Serum Albumin, Human
  • Severity of Illness Index
  • Telbivudine
  • Thymidine (adverse effects, analogs & derivatives, therapeutic use)
  • Time Factors
  • Treatment Outcome
  • Viral Load

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