Objective To investigate the efficacy of telbivudine treatment on HBV -infected patients with HBeAg-positive and its influencing factors. Methods 138 patients with HBeAg-positive were included in this study. They were treated with telbivudine for at least 48 weeks(40 patients for 96 weeks). The HBV serology ,HBV DNA and ALT levels were monitored. Results At 24 weeks,48 weeks and 96 weeks,the rates of HBeAg seroconversion were 17.39% ,34.78% and 55.0% ,respectively;and the rates of viral response were 84. 06% ,92.03% ,95.0% respectively. Moreover ,the rates of biochemical response were 93.48% ,95.65% ,95.0% Respectively. Furthermore, the response rates in patients were highly correlated with the HBV DNA levels at week 24. At the end of the observation period ,15 patients showed high serum levels of phosphocreatine kinase and one patient withdrew ,from this study because of serious muscular sore -ness. Conclusions Patients in this study appeared good tolerance towards telbivudine . Telbivudine resulted in the suppression of HBV DNA replication, the normalization of ALT and HBeAg seroconversion. HBV DNA level at week 24 could predict the antiviral activity at week 48 and 96.%目的 探讨HBeAg阳性慢性乙型肝炎初治患者服用替比夫定的48周,96周疗效以及影响因素.方法 给予138例HBeAg阳性慢性乙型肝炎初治患者口服替比夫定治疗48周,其中有40例患者口服替比夫定治疗96周,观察患者在治疗24、48和96周时的应答情况.结果 患者24、48、96周HbeAg血清转换率分别为17.39%、34.78%和55.0%,病毒学应答率分别为84.06%、92.03%、95.0%,生化学应答率分别为93.48%、95.65%、95.0%,48周和96周各项指标应答率高低与24周HBVDNA抑制水平呈正相关(P<0.01),本组患者中有15例发生磷酸肌酸激酶升高(65～717 U·L-1),其中1例48周时因肌肉酸痛停药.结论 替比夫定能有效抑制HBVDNA复制,使ALT复常,促进HBeAg血清转换.治疗24周的HBVDNA抑制水平可预测治疗48周及96周的疗效,患者耐受性较好.
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