Observation of sequential nucleoside analogue therapy following interferon failure on patients with HBeAg-positive chronic hepatitis B

Objective To evaluate the efficacy and safety of sequential nucleoside analogues therapy following interferon failure on patients with HBeAg-positive chronic hepatitis B. Methods One hundred and ten HBeAg-positive CHB patients were divided into telbivudine-treated and entecavir-treated group. The efficacy and safety of the two groups were assessed during a thirty-six months period. Results After thirty-six months, there were no significant differences in the proportion of ALT normalization and HBV DNA undetectable rate between the two groups. The seroconversion rate of HBeAg at 6, 12, 18, 24, 30, 36 months were significantly higher in the telbivudine group than in the entecavir group (21.2%vs.9.1%, 33.3%vs.13.6%, 36.4%vs.14.3%, 38%vs.13.3%, 40.5%vs.17.4%, 55.3%vs.31.2%, P<0.05). rtM204I Mutation was found 7 patients in telbivudine group and 0 in entecavir group, respectively. No apparent adverse effects were found in both groups. Conclusion Sequential nucleoside analogue therapy is effective for treatment of interferon failure patients with higher and faster biochemical response and virological response, and serum HBeAg seroconversion rate in telbivudine group is higher than that in entecavir group. Key words: Hepatitis B; Interferons; Telbivudine; Entecavir