Abstract: Objective To compare the efficacy and safety of telbivudine（LdT）and ADV in the treatment of patients with HBeAg-positive CHB. Methods 175 patients with HBeAg-positive CHB were randomly divided into LdT group（n=85 cases）and ADV group（n=90 cases），and the observation was 48 weeks. Results Compared with the ADV group，the LdT group had a very lower serum HBV DNA levels（P<0.01）and higher HBV DNA negative and ALT normalization rates at week 12，24，36 and 48（P<0.05 or P<0.01）；HBeAg negative or HBeAg/anti-HBe conversion and complete response in the LdT group were higher than those in the ADV group at week 12，24，36（P<0.05 or P<0.01）；2 cases in LdT group and 1 case in ADV group had virological rebound at week 48. Conclusions Telbivudine has a stronger inhibition of HBV replication and has a higher HBeAg negative or HBeAg/anti-HBe conversion rates.

Key words: Hepatitis B, Telbivudine, Adefovir dipivoxil, HBeAg