Review:Current Antiviral Therapy of Chronic Hepatitis B

StephenW

http://www.medscape.com/viewarticle/752641
From Alimentary Pharmacology & TherapeuticsReview ArticleCurrent Antiviral Therapy of Chronic Hepatitis B

W. S. Ayoub; E. B. Keeffe

Posted: 12/11/2011; Alimentary Pharmacology & Therapeutics. 2011;34(10):1145-1158. © 2011 Blackwell Publishing

Abstract
Background
The indications and endpoints for treatment of chronic hepatitis B continue to evolve. The aim of the therapy for chronic hepatitis B is to achieve a long-term continued suppression of the hepatitis B virus (HBV) DNA to prevent disease progression leading to the development of cirrhosis and hepatocellular carcinoma.
Aim To summarise current literature on therapy of chronic hepatitis B, with a focus on indications for therapy, preferred treatment options, and management of resistance and partial responders.
Methods A systematic review of the literature, with a focus on international guidelines, was performed.
Results Seven drugs are licensed for the treatment of chronic hepatitis B in many countries. The selection of a drug with high potency and low rate of resistance is essential to achieve rapid and long-term viral suppression. The prevention of the sequelae of antiviral drug resistance and appropriate management of viral breakthrough are major goals of current management. The addition or change to an antiviral agent that is not cross-resistant is critical to restore suppression of viral replication for patients with breakthrough resistance. Patient adherence to medication is essential to achieve adequate HBV DNA suppression.
Conclusions The current treatment strategy of chronic hepatitis B is now standard: initial selection of entecavir, tenofovir, or peginterferon alfa-2a. Future studies are required to determine if combination therapy using two oral agents or peginterferon with an oral agent with a high genetic barrier to resistance might be superior to standard current monotherapy.




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StephenW

从消化系统药理学与治疗学
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目前的抗病毒药物治疗慢性乙型肝炎

W · S ·阿尤布; E. B. Keeffe


发表于：2011年12月11日;消化系统药理学与治疗。 2011，34（10）:1145 - 1158。 © 2011布莱克韦尔出版


摘要

背景
的适应症和治疗慢性乙型肝炎的端点的继续发展。该疗法治疗慢性乙型肝炎的目的是实现一个长期继续抑制乙型肝炎病毒（HBV）的DNA，防止病情恶化，导致肝硬化和肝癌的发展。
目的
总结治疗慢性乙型肝炎治疗的适应症，首选的治疗方案和管理的阻力和部分应答的焦点，当前文学。
方法对文献进行系统的审查与国际准则的重点，是执行。
结果7种药物获准用于治疗慢性乙型肝炎在许多国家。一种药物高浓度和低电阻率的选择是至关重要的，以实现快速和长期的病毒抑制。抗病毒药物的耐药性和病毒突破的适当管理的后遗症的预防是当前管理的主要目标。添加或更改抗病毒药剂，不交叉耐药，以恢复患者的突破阻力抑制病毒复制的关键。患者坚持用药是必须达到足够的HBV DNA抑制。
结论
目前慢性乙型肝炎的治疗策略是现在的标准：恩替卡韦，替诺福韦，或聚乙二醇干扰素α- 2a的初始选择。未来的研究需要，以确定是否使用口服剂具有高基因屏障的抵抗两种口服剂或聚乙二醇干扰素联合治疗可能优于标准目前单药治疗。