Telbivudine is an antiviral drug used primarily in the therapy of hepatitis B. It is a disease when liver cells are affected by the hepatitis B virus. This disease may lead to liver cirrhosis and failure. However, a favourable effect of Telbivudine has been described even in patients with inflammatory cardiomyopathy caused by the parvovirus B19. This virus is frequently connected with this cardiomyopathy and with myocarditis.
Parvovirus B19 belongs to the viruses which are widespread in the worldwide population. The infection with this pathogen starts with the first contact of some human with parvovirus B19, which often “quietly exist“ inside the human body cells and usually does not cause other problems after the infection. However, in a noticeable amount of cases, the virus may cause severe complications. It may happen after some time from the first contact with the virus. For example, when another disease weakens the body. In this case, parvovirus B19 may cause rash diseases, anaemia or myocarditis and inflammatory cardiomyopathy. Parvovirus B19 does not damage the heart muscle directly during myocarditis. It does not affect the myocardium itself but the cells of the wall of vessels which nourish the heart muscle.
The effect of Telbivudin lies in the inhibition of replication of parvovirus (or hepatitis B virus) DNA, so the virus cannot spread further. Moreover, scientists have observed positive effects of Telvibudine on the immune system function and even its anti-inflammatory impact.
Let´s come back to the myocarditis. A German study has researched the effectiveness of this drug in both laboratory research and clinical trial. It consisted of a small group of patients with myocarditis caused by parvovirus B19. Research has discovered that Telbivudin has a protective effect on the cells of the vascular wall. In patients treated with this medicament, the improvement of symptoms, decrease in viral activity, and improvement of markers of heart muscle inflammation have been observed. Up to now, there is just this one small study researching the therapy of myocarditis with Telbivudin. So we need other studies until this drug may be used in the treatment of myocarditis.
Possible side-effects of Telbivudine are headache, malaise, abdominal pain, digestive problems, cough, muscle pain and increased levels of some enzymes in the blood. It cannot be administered together with interferon-alpha. It is needed to check the levels of blood enzymes during the therapy and the influence on metabolism, muscles and kidneys.
Author of the opening picture: Graham Beards
