Telbivudine therapy may shape CD4⁺ T‐cell response to prevent liver fibrosis in patients with chronic hepatitis B

Abstract

Telbivudine might slow down HBV-related liver fibrosis progression by restoring CD4(+) T-cell responses against HBV.

Persistently elevated circulating Th22 reversely correlates with prognosis in HBV‐related acute‐on‐chronic liver failure

“…In the present study, the frequencies of Th1 cells in CHB and HBV‐ACLF patients were decreased compared with HCs, which is consistent with the previous studies . Th1 cells play important roles in enhancing cytotoxic T lymphocyte activity, inducing anti‐HBV immunity, and liver inflammation. Our explanation for such decreased Th1 in HBV‐ACLF is that Th1 mediated specific HBV host immunity may be compromised, but increased uncontrollable non‐specific self‐destructive liver injury.…”

Telbivudine in chronic lymphocytic myocarditis and human parvovirus B19 transcriptional activity

“…15,46,47 Thus, for this clinical scenario, there is an unmet need to develop new immunomodulatory or antiviral therapy strategies that do not carry the risk of viral stimulation due to global immune suppression as it is known for cortisone. The antiviral and anti-inflammatory properties of telbivudine [24][25][26][27] inspired us to evaluate its potential to treat B19V-associated inflammatory cardiomyopathy. Given the vasculotrope nature of B19V 2,3 and the evidence that B19V modulates inflammatory signalling and apoptosis in endothelial cells, 20 we evaluated at first potential endothelial-protective effects of telbivudine in B19V-infected endothelial cells.…”

“…On the search for antiviral components that possess immunomodulatory and/or antiviral properties meaningful in the context of lympohycytic myocarditis and B19V persistance, we found the mode of action of telbivudine interesting. Although this antiviral nucleoside analogue reverse transcriptase inhibitor is especially effective for retroviral and para‐retroviral (hepatitis B viruses) infections, telbivudine has some pleiotropic immunomodulatory/anti‐inflammatory and interesting antiviral properties discussed to be theoretically able to interfere with the unique replication mode of B19V, too. In more detail, the finding that the single‐stranded B19V DNA genome replicates through a specific rolling hairpin mechanism to generate a double‐stranded DNA molecule mimicking DNA synthesis during the reverse transcription process comparable with retroviruses and hepatitis B viruses, the ability of telbivudine to preferentially inhibit the DNA‐dependent second strand DNA synthesis and its anti‐inflammatory effects, prompted us to investigate whether treatment with telbivudine is effective in myocarditis associated with B19V transcriptional activity.…”

“…Although this antiviral nucleoside analogue reverse transcriptase inhibitor is especially effective for retroviral and para‐retroviral (hepatitis B viruses) infections, telbivudine has some pleiotropic immunomodulatory/anti‐inflammatory and interesting antiviral properties discussed to be theoretically able to interfere with the unique replication mode of B19V, too. In more detail, the finding that the single‐stranded B19V DNA genome replicates through a specific rolling hairpin mechanism to generate a double‐stranded DNA molecule mimicking DNA synthesis during the reverse transcription process comparable with retroviruses and hepatitis B viruses, the ability of telbivudine to preferentially inhibit the DNA‐dependent second strand DNA synthesis and its anti‐inflammatory effects, prompted us to investigate whether treatment with telbivudine is effective in myocarditis associated with B19V transcriptional activity. Therefore, we investigated telbivudine in different in vitro settings to understand the possible mode of action and proved whether the results can be successfully translated to the clinical scenario by initiating a single‐patient‐use programme for patients severely suffering from EMB‐proven chronic lymphocytic myocarditis associated with cardiac B19V transcriptional activity.…”

Long‐term outcome of telbivudine versus entecavir in treating higher viral load chronic hepatitis B patients without cirrhosis

“…The mechanism for LdT increasing HBeAg and HBsAg seroconversions has not yet been clearly elucidated. Some authors found that LdT reduced the ratio of regulatory cells (CD4 + CD25 + Treg) in CHB patients; more studies showed that LdT maintains the Th1/Th2 cytokine balance, which might explain why patients who received LdT had higher rates of HBeAg, HBsAg seroconversions.…”