EFFICACY OF TELBIVUDINE IN THE TREATMENT OF HBeAg NEGATIVE CHRONIC HEPATITIS B WITH NORMAL BASELINE ALT LEVELS

Background: Pakistan remains in intermediate prevalence area for hepatitis B with an estimated carrier rate of 2.5%. Over last 10 years, treatment for HBV has improved, improving the prognosis and long term outcome. We conducted this trial to study the efficacy of Telbivudine (LdT) monotherapy in the treatment of HBeAg negative chronic hepatitis B infection with normal ALT levels. Methods: Ninety-six adults of both sexes suffering from HBeAg negative chronic hepatitis B who previously never had any antiviral treatment were recruited in this study between June 2008 and June 2011. LdT 600 mg daily was given to all the patients for two years. Results: Among 85 patients who successfully completed two years of LdT treatment, 54 were males and 31 females between 18 and 62 years of age. All had HBV DNA levels between 2.8 to 13.1 log 10 copies/ml. At the end of one year treatment, the proportion of the patients with serum HBV DNA levels undetectable by PCR was 85% which increased to 94% by the end of second year of treatment. HBsAg seroconversion rate was 2% at end of 1st year and 4.9% at the end of 2nd year. No patient was found to be exhibiting viral breakthrough during the treatment. Conclusion: Telbuvidine therapy is an effective option for the treatment of adult HBeAg negative CHB patients in our population.