Department of Infectious Diseases, Renmin Hospital of Wuhan University, Wuhan, China.
The objective of this study was to evaluate the short-term efficacy and safety of telbivudine therapy as compared to lamivudine therapy in liver failure patients with chronic hepatitis B virus (HBV) infection. These data were collected from 38 liver failure patients with chronic HBV infection who were randomly enrolled to one of the two treatments. All patients received comprehensive treatments; 20 patients were treated with telbivudine, and the other 18 patients were treated with lamivudine. The serum levels of HBV DNA, alanine aminotransferase, total bilirubin, prothrombin time activity, and creatine kinase were determined every 7 days for 8 weeks. The results showed that the serum HBV DNA levels in patients treated with either telbivudine or with lamivudine declined gradually after the 2nd week of treatment. However, HBV DNA levels in the telbivudine group fell to the lower limit of detection (<5 + E2 copies/ml) after the 5th week, which was more rapid than in the lamivudine group. In addition, the total bilirubin and prothrombin time activity of the patients with telbivudine treatment showed a more significant improvement as compared to the patients treated with lamivudine from the start of the 5th week. All patients tolerated telbivudine or lamivudine treatment well. The patients treated with telbivudine did not have elevated serum creatine kinase or myopathic symptoms during the 8-week treatment period. Thus, telbivudine treatment is superior to lamivudine treatment in improving the condition of patients with liver failure as a result of chronic HBV infection in the short term.