Efficacy and safety of interferon-αsequential telbivudine in the treatment of HBeAg-positive chronic hepatitis B / 中国生化药物杂志

ABSTRACT

Objective To explore the efficacy and safety of sequential telbivudine ( LDT) therapy following interferon-α( IFN-α) in hepatitis B e antigen (HBeAg) positive chronic hepatitis B patients.Methods 94 chronic hepatitis B patients in our hospital hepatitis clinic archives from August 2008 to September 2013 were divided into two groups, 45 patients treated with LDT following IFN-αdue to unsatisfactory response to peginterferon-α-2a (peg-IFN-α-2a)treatment in the sequential group and 49 patients treated with LDT initially in the controlled group.In the sequential group, 22 patients failed to respond to IFN-αtreatment, 4 patients obtained IFN-resistance, 6 patients developed severe side effects, 1 patients had pre-C mutation and 12 patients switched to LDT due to economic factors or fertility requirement.The biochemical response and virological response, virological breakthrough and serological response were observed.Chi-square test was adapted for data analysis.Results After 32.35 months of LDT therapy, 88.9%(40/45) patients had with HBV-DNA <100 IU/mL in the experiment group compared with 44.9%(22/49) patients in the control group (P<0.05).The rates of HBeAg loss and HBeAg seroconversion in the experiment group were 53.3%(24/45) and 51.1%(23/45) respectively, which were significantly higher than that of the control group, 24.5%(12/49) and 24.5% (12/49) (P<0.05).6.7% (3/45) patients developed virological breakthrough in the sequential group compared with 34.7%(17/49) in the control group (P<0.05).Above results suggested the synergistic antiviral activity between peg-IFN-α-2a and LDT.Conclusion Sequential LDT therapy following peg-IFN-α-2a is better efficacy and safety compared with treating patients with LDT alone initially.