Hepatitis B virus (HBV) is the primary cause of chronic viral hepatitis worldwide. Currently, there are 5 oral nucleos(t)ide analogs (NAs) approved for chronic hepatitis B (CHB) treatment and include lamivudine, adefovir, telbivudine (LtD), entecavir (ETV), and tenofovir disoproxil fumarate (TDF). ETV and TDF are those with higher anti-viral efficacy and lower resistance rates, whereas LtD shows similar efficacy but has a higher risk for viral resistance in long-term monotherapy. However, LtD carries several advantages that must be considered and are worthy of discussion. Compared to other NAs, LtD showed a potential renal protective effect particularly in patients with mild renal insufficiency. Moreover, data have suggested that LtD could be safely administered in highly viremic pregnant women for reducing the vertical transmission risk despite vaccination and HB immunoglobulin prophylaxis. In addition, reported adverse events are rare, usually transitory with patients’ recovery after treatment cessation. Finally, the lower cost and the easy availability compared to ETV and TDF render LtD a valid first line alternative for CHB treatment in economically less-developed regions.
Keywords: Anti-viral treatment, chronic HBV infection, HBV, nucleos(t) ide analogue