Antiviral Therapy of Chronic Hepatitis B

نویسندگان

  • Florian van Bömmel
  • Thomas Berg
چکیده

Since the licensing of lamivudine in 1999, the treatment of chronic hepatitis B has been revolutionized by the introduction of oral nucleoside and nucleotide analogues (NAs), which act as inhibitors of the HBV polymerase. The effectiveness of the first of these substances was limited by incomplete response and resistance development in many patients, but today, highly potent substances are available that make a reliable and durable suppression of HBV replication, a reduction of necroinflammatory activity in the liver, and even a reversion of liver fibrosis achievable for almost all patients. Beyond that, NA treatment can prevent the development of hepatocellular carcinoma in many patients. HBeAg seroconversion appears in approximately 50% of all HBeAg-positive patients during NA treatment. However, the ideal treatment endpoint, the serologic loss of HBsAg, remains a rare event almost exclusively achievable for HBeAg-positive patients. After cessation of the treatment, HBV replication tends to relapse in most patients, which is why the duration of NA treatment is indefinite. Future treatment strategies should aim at tailoring individual NA treatment regimens to increase HBs loss rates and optimize treatment duration. © 2014 S. Karger AG, Basel Published online: July 15, 2014 Florian van Bömmel, MD Hepatology Section, Department for Gastroenterology and Rheumatology University Hospital Leipzig Liebigstrasse 20, DE–04013 Leipzig (Germany) E-Mail florian.vanboemmel @ medizin.uni-leipzig.de © 2014 S. Karger AG, Basel 0300–5526/14/0574–0171$39.50/0

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Frequency of YMDD mutations in patients with chronic hepatitis B untreated with antiviral medicines

 Abstract Background: Investigators were suspicious of tyrosine-methionine-aspartate-aspartate (YMDD) mutations occurred only in patients who were treated by lamivudine. However, YMDD mutations of hepatitis B virus gene (HBV DNA) in patients with chronic hepatitis B (CHB) untreated with antiviral medicines was reported in some studies. The aim of this study was to evaluate YMDD mutations in Ira...

متن کامل

Vitiligo Complicating chronic Hepatitis B patients treated with α-Interferon (Report of two cases)

α-Interferon is an antiviral agent used in treatment of chronic hepatitis B. Triggering of the underlying autoimmune disease or exacerbation of pre-existing auto immune disease is documented with α-interferon, but there are few reports about occurrence of autoimmune disorders such as systemic lupus erythematosus, Vitiligo, hypo and hyperthyroidism after administration of α-interferon in the lit...

متن کامل

بررسی عوامل مرتبط با شدت فیبروز کبد در بیماران مبتلا به هپاتیت‌های مزمن B و C

   Background & Aim: Viral hepatitis has existed since the creation of human. The estimated prevalence of hepatitis is about 3-5%. For patients with chronic hepatitis C and moderate to severe liver fibrosis, antiviral therapy is strongly suggested, while the cases without fibrosis or with mild liver fibrosis are often followed up without receiving antiviral therapy. The purpose of the present s...

متن کامل

Antiviral therapy for hepatitis B in special populations.

There has been much progress in antiviral therapy for chronic hepatitis B; however, antiviral therapy for hepatitis B in special populations is still very challenging. Here, we review antiviral therapy for hepatitis B in special populations, including children and pregnant patients, patients with hepatitis-B-related cirrhosis, patients with acute hepatitis B and chronic hepatitis B surface anti...

متن کامل

[Antiviral therapy in chronic hepatitis B].

Treatment of chronic hepatitis B remains a clinical challenge. Long-term viral suppression is a major goal of antiviral therapy to improve the clinical outcome of the patients. Antiviral treatment of chronic hepatitis B relies currently on immune modulators such as interferon alpha and its pegylated form, and viral polymerase inhibitors. Because of the slow kinetics of viral clearance and the s...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره   شماره 

صفحات  -

تاریخ انتشار 2014