Telbuvidine monotherapy in the treatment of HBeAg positive chronic hepatitis B infection with normal baseline ALT levels

ABSTRACT

To study the effect of Telbuvidine [LDT] mono therapy in the treatment of HBeAg positive Chronic Hepatitis B infection [CHB] with normal ALT levels. Ninety HBe antigen [HBeAg] positive CHB infection patients were enrolled and followed between June 2008 and June 2011. All of them had ALT levels less than twice the upper normal limit [Mean 36.9 SD 19.9]. All patients were HBeAg positive, had serum DNA level >10[4] copies/ml and never had previously received anti HBV treatment. All patients were given LDT 600mg daily as initial antiviral treatment for two years. Out of 83 patients who continued the treatment as per protocol, 59 were males and 24 were females between ages of 21 and 50 years. Baseline HBV DNA levels were 7.82x10[7] copies/ml [Range 4.8x10[4]-8.3x10[9] copies/ml]. By the end of first year [52 weeks] the mean decrease in serum HBV DNA levels was 7.88 log[10] copies/ml and the proportion of patients having undetectable HBV DNA levels was 73%. At the end of second year of therapy [96 weeks] the percentage of undetectable HBV DNA levels increased to 86%. At the end of 1[st] [52 weeks] and 2[nd] [96 weeks] HBeAg seroconversion rates were 62% and 86% while HBsAg seroconversion was 8% and 13% respectively. LDT is a reasonable cost effective therapy for HBeAg reactive CHB patients with normal baseline ALT levels resulting in a significant serological and virological response and was well tolerated in our population of Khyber Pukhtunkhwa