Comparison of Telbivudine and Entecavir Therapy on Nephritic Function and Drug Resistance in Patients with Hepatitis B Virus-Related Compensated Cirrhosis

• Published in: Cellular physiology and biochemistry Vol. 40; no. 1-2; pp. 370 - 378
• Main Authors: Shen, Huajiang, Ding, Feng, Wang, Zhiwei, Sun, Fang, Yu, Yafeng, Zhou, Jiankang, Xu, Wenfang, Ni, Jianchao, Wang, Jiangang, Yang, Yida
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Cell Physiol Biochem Press GmbH & Co KG 01.01.2016
• Subjects: Creatinine - blood; DNA, Viral - genetics; Drug Resistance, Viral - drug effects; eGFR; ETV; Female; Glomerular Filtration Rate; Guanine - adverse effects; Guanine - analogs & derivatives; Guanine - pharmacology; Guanine - therapeutic use; HBV-related compensated cirrhosis; Hepatitis B virus - physiology; Humans; Kidney - drug effects; Kidney - physiopathology; Kidney Function Tests; LDT; Liver Cirrhosis - blood; Liver Cirrhosis - drug therapy; Liver Cirrhosis - physiopathology; Liver Cirrhosis - virology; Male; Middle Aged; Nephritic function; Original Paper; Telbivudine; Thymidine - adverse effects; Thymidine - analogs & derivatives; Thymidine - pharmacology; Thymidine - therapeutic use; eGFR; HBV-related compensated cirrhosis; Nephritic function; LDT; ETV
• ISSN: 1015-8987; 1421-9778
• DOI: 10.1159/000452552

Background: To compare the impact of telbivudine (LDT) and entecavir (ETV) administration on nephritic function. Method: One hundred thirty patients diagnosed with hepatitis B virus (HBV)-related compensated cirrhosis were randomly divided into LDT (600 mg/d) or ETV (0.5 mg/d) groups. Results: The drug resistance rate was higher following LDT treatment compared to ETV treatment (16.9% vs. 1.5%, P=0.0006). The mean creatinine level decreased compared to baseline in the LDT group (0.81 vs. 0.94 mg/dl, P=0.000). The change in median glomerular filtration rate (eGFR) compared to baseline in the LTD and ETV groups was 22.3 and -3.3, respectively, at 2 years (P=0.000). In patients with mild nephritic injury (eGFR< 90 ml/min/1.73m 2 ), the median eGFR increased by 28.0 ml/min/1.73m 2 in the LDT group and decreased by 4.3 ml/min/1.73m 2 in the ETV group (p=0.000). The eGFR in 88.5% of patients (23/26) from the LDT group increased > 90 ml/min/1.73m 2 . The percentage of patients with an eGFR > 90 ml/min/1.73m 2 increased from 60.0% to 92.3% in the LDT group and from 64.6% to 69.2% in the ETV group. Conclusion: In patients with HBV-related compensated cirrhosis, LDT treatment was more effective in protecting nephritic function and was associated with a higher drug resistance rate, but did not contribute to a better outcome compared with ETV treatment.