Abstract: Objective This study was aimed to explore the clinical efficacy of sequential telbivudine treatment in serum HBeAg-positive chronic hepatitis B patients with partial response to standardized pegylated interferon alpha-2a therapy. Methods 63 patients with HBeAg-positive chronic hepatitis B were recruited in this study between January 2016 and February 2017 who had been treated with pegylated interferon alpha-2a for 48 weeks, and got partial response to the regimen. Out of them, 31 received tibivudine for further 48 week treatment, and 32 discontinued any treatment. All the patients were followed-up for 24 weeks. Results At week 24, week 48 of treatment and 24 week follow-up, the serum HBeAg negative rates in sequential treatment group were 22.5%, 25.8% and 35.4%, significantly higher than 0.0%, 3.2% and 3.2%(P<0.05) in patients who discontinued any treatment, at treatment or observation week 48 and follow-up week 24, serum HBV DNA negative rates in sequential treatment patients were 90.3% and 87.0%, significantly higher than 34.3% and 18.7%(P<0.05) in the control, and serum alanine aminotransaminase normalization rates in patients with sequential treatment were 96.7% and 90.3%, significantly higher than 75.0% and 25.0%(P<0.05) in the latter; at treatment or observation week 48 and follow-up week 24, serum HBV DNA level in patients with sequential treatment were (2.6±0.3)lg IU/mL and (1.9±0.1)lg IU/mL, siginificantly lower than 【(4.5±0.7)lgI U/mL and (5.5±0.2)lgIU/mL, P<0.05】, serum ALT level were (56.3±2.4)IU/L and (43.3±3.1)IU/L, significantly lower than 【(60.1±7.2)IU/L and (71.3±2.8)IU/L,respectively, P<0.05】 in the control, and at follow-up week 24, serum HBsAg level in patients receiving telbivudine was (2.0±0.2)lg IU/mL, significantly lower than 【(2.6±0.3)lg IU/mL, P<0.05】 in the control; 9 patients(29.0%)had transient serum CK elevation and got back to normal during telbivudine treatment. Conclusion The sequential administration of telbivudine for further treatment might effectively improve the negative serum conversion rate of HBeAg and HBV DNA in patients with HBeAg-positive chronic hepatitis B after failed pegylated interferon alpha-2a treatment.

Key words: Hepatitis B, Pegylated interferon alpha-2a, Partial response, Telbivudine, Efficacy