Nucleos(t)ide analogues for hepatitis B virus: Strategies for long-term success

作者：Chien Rong Nan; Liaw Yun Fan^*

来源：Best Practice & Research in Clinical Gastroenterology, 2008, 22(6): 1081-1092.

DOI：10.1016/j.bpg.2008.11.003

• cirrhosis
• drug resistance
• hepatitis B virus
• hepatocellular carcinoma
• nucleos(t)ide analogue
• lamivudine
• adefovir
• entecavir
• telbivudine

Studies in the past decades have shown that active hepatitis B virus (HBV) replication is the key driver of liver injury and disease progression, and thus sustained viral suppression is of paramount importance in the management of chronic HBV infection. The nucleos(t)ide analogues lamivudine, adefovir, entecavir, telbivudine and tenofovir are potent inhibitors of HBV polymerase/reverse transcriptase activity and are highly effective in the suppression of HBV replication, but rarely eliminate the virus. Long-term therapy is usually required to achieve sustained hepatitis B e antigen seroconversion, HBV DNA suppression, ALT normalization and fibrosis reversal. Maintained long-term therapy has been demonstrated to significantly lower the rate of hepatic decompensation and development of cirrhosis or hepatocellular carcinoma. However, drug resistance is a serious risk on prolonged nucleos(t)ide analogue therapy, and this poses a critical challenge. Prevention and proper management of drug resistance are crucial to ensure long-term success.

• 出版日期2008
• 单位长春大学