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Review
Effects of antiviral therapy in patients with chronic hepatitis B and cirrhosis
Masako Okada, Masaru Enomoto, Norifumi Kawada & Mindie H. Nguyen
Pages 1095-1104 | Received 27 Feb 2017, Accepted 27 Jul 2017, Accepted author version posted online: 28 Jul 2017, Published online: 07 Aug 2017
Download citation http://dx.doi.org/10.1080/17474124.2017.1361822
ABSTRACT
Introduction: Hepatitis B virus (HBV) infection is the major cause of cirrhosis worldwide. The ultimate goal of current antiviral treatments for chronic hepatitis B (nucleos(t)ide analogs and interferon-α) is to prevent the development of end-stage liver diseases.
Areas covered: We present a review of the current literature on antiviral therapy in patients with chronic hepatitis B and cirrhosis. Medline search was performed to identify relevant literature from 1993 through January of 2017.
Expert commentary: One randomized controlled trial and a number of observational studies have shown that nucleos(t)ide analogs can decrease the incidence of hepatocellular carcinoma (HCC) in chronic hepatitis B patients with advanced fibrosis. Data from clinical trials of entecavir and tenofovir have shown that histological improvement and regression of fibrosis can be achieved in the majority of patients with chronic hepatitis B by successful viral suppression. Entecavir and tenofovir are the preferred antiviral agents for treatment of chronic hepatitis B in patients with cirrhosis due to their high antiviral potency and high genetic barrier to resistance. Pegylated interferon-α is another therapeutic option for chronic hepatitis B patients with well-compensated cirrhosis. However, interferon therapy is contraindicated in patients with decompensated cirrhosis, and evidence for reduced HCC is currently insufficient.
KEYWORDS: Hepatocellular carcinoma (HCC), entecavir, fibrosis, interferon-α, nucleos(t)ide analogs, tenofovir
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发表于 2017-11-9 18:37