Abstract: Objective To investigate the efficacy of telbivudine (LDT) in patients with hepatitis B virus (HBV)-related decompensated liver cirrhosis and evaluate its influence on renal function. Methods In the retrospective analysis, 72 patients with HBV-related decompensated liver cirrhosis in our hospital from April 2012 to October 2015 received LDT (600 mg/d) antiviral therapy. The levels of alanine aminotransferase (ALT), total bilirubin (TBil), albumin (Alb), prothrombin time (PT), ascites, Child-Pugh integral, HBV DNA load, HBV DNA undetectable rate and resistance mutation were evaluated at baseline, week 24 and 48. Serum creatinine (CR) and estimated of glomerular filtration rate (eGFR) were also monitored. Comparisons among baseline, week 24 and 48 were carried out by chi-square test and t-test. Results At week 24, mean levels of ALT, TBil, HBV DNA load and HBV DNA undetectable rate were 46.12 U/L, 44.31 mol/L, 1.89 lg copies/mL and 75.00%, respectively. All results were significantly improved, as compared with those at baseline (P<0.05). Meanwhile, resistance mutations occurred in 2 cases, and ascites regression had not been reported. At week 48, levels of Alb and PT were 34.16 g/L and 15.09 sec, and Child-Pugh integral was significantly decreased as compared to that at baseline (P<0.05). In addition, resistance mutations occurred in 5 cases, and ascites regression was found in 3 cases. Compared with those at baseline, CR level reduced to 0.83 mg/dL and eGFR level raised to 108.48 mL/(min·1.73 m²) after 48-week treatment (P<0.05). Furthermore, 9 (23.08%) patients with mild renal impairment improved with eGFR≥90 mL/(min·1.73 m²). Conclusion LDT is a crucial strategy for inhibiting virus replication and improving liver function in chronic hepatitis B patients with decompensated liver cirrhosis. Although prolonging treatment can enhance therapeutic efficacy, it also increases resistance mutations risk. In terms of patients with mild renal impairment, LDT might be an appropriate option for its improvement in renal function.

Key words: Telbivudine, Chronic hepatitis B, Liver cirrhosis, Efficacy, Renal function