Telbivudine therapy for gravidas with chronic hepatitis B infection and patients at risk of renal impairment

Abstract

Hepatitis B virus infection is currently the most important cause of chronic viral hepatitis worldwide and is one of the most frequent causes of end-stage liver disease. With the international implementation of the hepatitis B vaccine and combined prophylaxis for infants born to HBsAg(+) mothers, the prevalence of hepatitis B has decreased remarkably. However, intra-uterine transmission has become a critical bottleneck for eliminating hepatitis B infection. The efficacy of nucleos(t)ide analogs on inhibiting hepatitis B replication has been widely confirmed, and the quality of life and the survival of individuals with chronic hepatitis B (CHB) have improved to a great degree. However, with the availability of long-term antiviral treatment and the ever increasing ageing population, renal disorders should be considered when choosing antiviral medicines. The antiviral efficacy and safety of telbivudine (LdT) have been shown in patients with CHB infection, and LdT is approved as a class B drug for pregnancy. Furthermore, the renal protective function of LdT has been demonstrated recently. In this review, we will focus on the efficacy and safety of LdT in gravidas with CHB infection, as well as the renal protective function of LdT in CHB patients. LdT might provide physicians with a solid option for effectively treating patients with CHB, especially gravidas or those either with or at risk of renal impairment.

S afety and adherence to the long-term treatment with nucleoside and nucleotide analogues in patients with chronic hepatitis B

“…Приверженность к терапии. При лечении энтекавиром хорошая приверженность к терапии (>97%) отмечена у 59 (91%) пациентов, удовлетворительная (90-97%) -у 2 (3%) и плохая (<90%) -у 4 (6%) пациентов, при лечении тенофовиром -у 23 (92%), 1 (4%) и 1 (4%) (19,8) 20 (19,8) 3 (2,9) пациентов, соответственно, при лечении телбивудином -у 16 (70%), 1 (4%) и 6 (26%) пациентов.…”

“…Лечение ХГВ предполагает длительный прием АН (не менее 3-5 лет), а в некоторых случаях, в частности, при циррозе печени, может потребоваться и пожизненное лечение, что определяет актуаль ность оценки безопасности и приверженности к терапии [6][7][8]. Низкая приверженность снижает эффективность лечения, увеличивает риск осложнений , а также способствует селекции резистентных штаммов вируса [9][10][11][12][13].…”

Effect of tenofovir disoproxil and telbivudine on the growth and development of infants by blocking mother-to-child transmission of hepatitis B virus

“…Antiviral therapy with Class B drugs including tenofovir disoproxil and telbivudine are recommended for pregnant women with hepatitis B [7]. Although tenofovir disoproxil and telbivudine have been studied frequently for pregnant women with hepatitis B, the comparison of effectiveness of their application in pregnant women have not been adequately explored [8][9][10]. In addition, tenofovir disoproxil and telbivudine are rarely reported on long-term growth and neuropsychological development in infants.…”