In this issue, Chan and colleagues (17) compared the antiviral efficacy of telbivudine and adefovir dipivoxil at 24 weeks of therapy. In addition, they evaluated the strategy of switching from adefovir to telbivudine at 24 weeks. The authors randomly assigned 135 HBeAg-positive patients with elevated ALT levels to 1 of 3 treatment groups: telbivudine, 600 mg/d for 52 weeks; adefovir, 10 mg/d for 52 weeks; or adefovir, 10 mg/d for 24 weeks, followed by telbivudine, 600 mg/d for 28 weeks. To compare the 2 drugs, the authors used the reduction in HBV DNA level at 24 weeks relative to baseline DNA level as the primary end point. The secondary end point was the reduction in DNA levels at 52 weeks among the 3 groups. At 24 weeks, telbivudine achieved better viral suppression than adefovir (−6.3 log10 copies/mL vs. −4.97 log10 copies/mL [30% vs. 12% of patients with undetectable HBV DNA], respectively; P < 0.001). However, at 52 weeks, patients who received telbivudine, adefovir, or both drugs had similar viral suppression relative to baseline in the unadjusted analysis (−6.56, −5.99 and −6.44 log10 copies/mL, respectively; P = 0.28), and a similar proportion among the groups had undetectable HBV DNA (60%, 40%, and 54%, respectively; P = 0.067).