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Standard Hepatitis B Treatment Bested by Newcomer
Date:12/19/2007

he liver, which can lead to liver cancer or liver failure.

The goal of treatment is to keep levels of the hepatitis B virus as low as possible. Even if hepatitis B levels become so low that they're undetectable, long-term treatment is still required to prevent recurrence. People with hepatitis B are tested to see if they are positive or negative for E-antigens. A positive result on the E-antigen test often indicates a stronger infection, according to the Hepatitis B Foundation. Someone with a positive result is referred to as HBeAg-positive.

While there are several treatment options available to suppress the virus, one problem is that people can develop resistance to these drugs. Two new drugs, entecavir (Baraclude) and telbivudine, have been approved to treat hepatitis B since 2005.

The current study looked at how effective telbivudine is compared to the standard first-line treatment, lamivudine.

The researchers randomly assigned 1,370 people with chronic hepatitis B to receive either 600 milligrams of telbivudine or 100 milligrams of lamivudine once daily.

After a year of treatment, 75.3 percent of HBeAg-positive people taking telbivudine showed a therapeutic response versus 67 percent of those on lamivudine. In HBeAg-negative people, 64.7 percent of those on telbivudine had a response compared to 56.3 percent of those on lamivudine.

The number of study volunteers who had undetectable levels of hepatitis B virus by the end of the treatment year were much greater for those on telbivudine. In HBeAg-positive people, 60 percent achieved undetectable levels on telbivudine versus 40.4 percent for those taking lamivudine. For HBeAg-negative study participants, telbivudine brought viral levels down to undetectable for 88.3 percent compared to 71.4 percent for lamivudine. Telbivudine also got those viral levels down about five to six weeks faster, on average, than lamivudine.

Resistance developed in 5
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