Telbivudine (NV 02B) is a Hepatitis B Virus Nucleoside Analog Reverse Transcriptase Inhibitor. The mechanism of action of telbivudine is as a Nucleoside Reverse Transcriptase Inhibitor. The chemical classification of telbivudine is Nucleoside Analog.

Telbivudine significantly increases the levels of tumor necrosis factor-alpha and interleukin-2 in macrophages (induced by MHV-3) as well as serum levels of interferon-gamma. It is phosphorylated by cellular thymidine kinase into an active triphosphate form, with an intracellular half-life of 14 hours. While enhancing the proliferation and secretion capabilities of T-cells, Telbivudine does not affect the cytotoxicity against infected hepatocytes. Furthermore, it inhibits the expression of programmed death ligand 1 in T-cells. Despite mutations such as N236T and A181V/A194T, Telbivudine remains active at increased magnitudes of 0.5 and 1.0 times, respectively. The differences in resistance between lamivudine and Telbivudine are due to Telbivudine's inactivity against the lamivudine-resistant HBV strain L180M/M204V/I mutation, though it remains active against the M204V single mutation.