Effect of Lamivudine and Telbivudine on Biochemistry,Virology and Hepatohistology in Hepatitis B Antiviral Treatment

Objective To study the effect of lamivudine and telbivudine on biochemistry,virology and hepatohistology in hepatitis B antiviral treatment.Methods Patients with chronic hepatitis B were randomized into lamivudine group(19 cases) and telbivudine group(16 cases),with each group taking lamivudine or telbivudine per os for 104 weeks.AST,ALT,and HBV DNA quantification were examined periodically and changes in hepato-histology before treatment and at week 52 were compared.Results Telbivudine group showed a significant higher rate of ALT normalization(75.0%),therapeutic response(81.2%),viral response(56.3%) at week 52 and a significantly higher rate of HBeAg negative conversion(56.3%) at week 104 compared with lamivudine group(36.8%,36.8%,21.1% and 21.1%,respectively,P0.05).At week 24,52 and 104,the HBV DNA negative conversion rates of telbivudine group(50.0%,62.5% and 50.0%,respectively) had no statistical difference compared with that of the lamivudine group(P0.05);HBV DNA level was both significantly reduced at week 24 in the two groups(P0.01),but there was no statistical difference between the two groups(P0.05);Telbivudine group reduced greater in HBV DNA at week 52 and 104 than lamivudine group,the difference between the two groups was significant(P0.05).In both two groups,hepatic fibrosis(S) at week 52 was relieved significantly compared with baseline(with P valued 0.0437 and 0.009,both0.05) in lamivudine and telbivudine respectively.However,there was no statistical difference between the two groups(P0.05).At week 52,significant improvement in hepatic inflammation(G) compared with baseline was seen in telbivudine group(P0.05),while there was no significant improvement in lamivudine group(P0.05).Telbivudine exhibited more significant improvement in hepatic inflammation(G) than lamivudine(P0.05).Conclusion Telbivudine is superior to lamivudine in the inhibition of HBV DNA replication,drug resistance rate,rebound of viral replication rate and the improvement of liver tissues.