Telbuvidine monotherapy in the treatment of hbeag positive chronic hepatitis B infection with normal baseline alt levels

Objective: To study the effect of Telbuvidine (LDT) monotherapy in the treatment of HBeAg positive Chronic Hepatitis B infection (CHB) with normal ALT levels. Methodology: Ninety HBe antigen (HBeAg) positive CHB infection patients were enrolled & followed between June 2008 and June 2011. All of them had ALT levels less than twice the upper normal limit 4 (Mean 36.9 SD 19.9). All patients were HBeAg positive, had serum DNA level &>10 copies/ml and never had previously received anti HBV treatment. All patients were given LDT 600mg daily as initial antiviral treatment for two years. Results: Out of 83 patients who continued the treatment as per protocol, 59 were males and 24 were 7 females between ages of 21 and 50 years. Baseline HBV DNA levels were 7.82x10 copies/ml (Range 4 9 4.8x10 -8.3x10 copies/ml). By the end of first year (52 weeks) the mean decrease in serum HBV DNA levels 10 was 7.88 log copies/ml and the proportion of patients having undetectable HBV DNA levels was 73%. At the end of second year of therapy (96 weeks) the percentage of undetectable HBV DNA levels increased to st nd 86%.At the end of 1 (52weeks) and 2 (96weeks) HBeAg seroconversion rates were 62 % and 86% while HBsAg seroconversion was 8% and 13% respectively. Conclusion: LDT is a reasonable cost effective therapy for HBeAg reactive CHB patients with normal baseline ALT levels resulting in a significant serological and virological response and was well tolerated in our population of Khyber Pukhtunkhwa.