Review article: current antiviral therapy of chronic hepatitis B
Summary Background The long‐term goals of therapy for chronic hepatitis B are to reduce serum HBV DNA to low or undetectable levels and ultimately reduce or prevent the development of cirrhosis and hepatocellular carcinoma. Aim To review the current treatment of chronic hepatitis B, with a focus o...
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| Veröffentlicht in: | Alimentary pharmacology & therapeutics 2008-07, Vol.28 (2), p.167-177 |
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| container_title | Alimentary pharmacology & therapeutics |
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| creator | AYOUB, W. S. KEEFFE, E. B. |
| description | Summary
Background The long‐term goals of therapy for chronic hepatitis B are to reduce serum HBV DNA to low or undetectable levels and ultimately reduce or prevent the development of cirrhosis and hepatocellular carcinoma.
Aim To review the current treatment of chronic hepatitis B, with a focus on diagnosis and management of resistance and active management of suboptimal responses.
Methods A systematic review of the literature, with a focus on recent guidelines, was undertaken.
Results Among the six drugs licensed for the treatment of chronic hepatitis B in the US, the preferred agents in 2008 will include entecavir, peginterferon alfa‐2a, possibly telbivudine, and tenofovir following licensure. When using an oral agent, a major focus of management is on the selection of a drug with high potency and low rate of resistance, and active on‐treatment management to optimize therapy. Preventing the sequelae of antiviral drug resistance and appropriate management when resistance is initially detected are also the major focus of current management. The addition of an antiviral agent that is not cross‐resistant is critical to restore suppression of viral replication.
Conclusions Newer agents and modified treatment strategies, especially using combination therapy, hold promise to optimize the management of patients with chronic hepatitis B by achieving the high potency and the lowest rate of resistance. |
| doi_str_mv | 10.1111/j.1365-2036.2008.03731.x |
| format | Article |
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Background The long‐term goals of therapy for chronic hepatitis B are to reduce serum HBV DNA to low or undetectable levels and ultimately reduce or prevent the development of cirrhosis and hepatocellular carcinoma.
Aim To review the current treatment of chronic hepatitis B, with a focus on diagnosis and management of resistance and active management of suboptimal responses.
Methods A systematic review of the literature, with a focus on recent guidelines, was undertaken.
Results Among the six drugs licensed for the treatment of chronic hepatitis B in the US, the preferred agents in 2008 will include entecavir, peginterferon alfa‐2a, possibly telbivudine, and tenofovir following licensure. When using an oral agent, a major focus of management is on the selection of a drug with high potency and low rate of resistance, and active on‐treatment management to optimize therapy. Preventing the sequelae of antiviral drug resistance and appropriate management when resistance is initially detected are also the major focus of current management. The addition of an antiviral agent that is not cross‐resistant is critical to restore suppression of viral replication.
Conclusions Newer agents and modified treatment strategies, especially using combination therapy, hold promise to optimize the management of patients with chronic hepatitis B by achieving the high potency and the lowest rate of resistance.</description><identifier>ISSN: 0269-2813</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/j.1365-2036.2008.03731.x</identifier><identifier>PMID: 18466358</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject><![CDATA[Adenine - analogs & derivatives ; Adenine - therapeutic use ; Antiviral Agents - therapeutic use ; Biological and medical sciences ; Carcinoma, Hepatocellular - prevention & control ; Deoxycytidine - analogs & derivatives ; Deoxycytidine - therapeutic use ; Digestive system ; Drug Resistance, Viral ; Emtricitabine ; Gastroenterology. Liver. Pancreas. Abdomen ; Guanine - analogs & derivatives ; Guanine - therapeutic use ; Hepatitis B virus ; Hepatitis B virus - physiology ; Hepatitis B, Chronic - diagnosis ; Hepatitis B, Chronic - drug therapy ; Human viral diseases ; Humans ; Infectious diseases ; Interferon-alpha - therapeutic use ; Lamivudine - therapeutic use ; Liver Cirrhosis - prevention & control ; Medical sciences ; Nucleosides - therapeutic use ; Organophosphonates - therapeutic use ; Pharmacology. Drug treatments ; Polyethylene Glycols - therapeutic use ; Pyrimidinones - therapeutic use ; Recombinant Proteins ; Reverse Transcriptase Inhibitors - therapeutic use ; Tenofovir ; Thymidine - analogs & derivatives ; Viral diseases ; Viral hepatitis ; Virus Replication]]></subject><ispartof>Alimentary pharmacology & therapeutics, 2008-07, Vol.28 (2), p.167-177</ispartof><rights>2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4941-9a723e64fc216bac602b6811433cefcc03058af73db9704452fb687cd25575473</citedby><cites>FETCH-LOGICAL-c4941-9a723e64fc216bac602b6811433cefcc03058af73db9704452fb687cd25575473</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2036.2008.03731.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2036.2008.03731.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,1430,27911,27912,45561,45562,46396,46820</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20463496$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18466358$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>AYOUB, W. S.</creatorcontrib><creatorcontrib>KEEFFE, E. B.</creatorcontrib><title>Review article: current antiviral therapy of chronic hepatitis B</title><title>Alimentary pharmacology & therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Summary
Background The long‐term goals of therapy for chronic hepatitis B are to reduce serum HBV DNA to low or undetectable levels and ultimately reduce or prevent the development of cirrhosis and hepatocellular carcinoma.
Aim To review the current treatment of chronic hepatitis B, with a focus on diagnosis and management of resistance and active management of suboptimal responses.
Methods A systematic review of the literature, with a focus on recent guidelines, was undertaken.
Results Among the six drugs licensed for the treatment of chronic hepatitis B in the US, the preferred agents in 2008 will include entecavir, peginterferon alfa‐2a, possibly telbivudine, and tenofovir following licensure. When using an oral agent, a major focus of management is on the selection of a drug with high potency and low rate of resistance, and active on‐treatment management to optimize therapy. Preventing the sequelae of antiviral drug resistance and appropriate management when resistance is initially detected are also the major focus of current management. The addition of an antiviral agent that is not cross‐resistant is critical to restore suppression of viral replication.
Conclusions Newer agents and modified treatment strategies, especially using combination therapy, hold promise to optimize the management of patients with chronic hepatitis B by achieving the high potency and the lowest rate of resistance.</description><subject>Adenine - analogs & derivatives</subject><subject>Adenine - therapeutic use</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Hepatocellular - prevention & control</subject><subject>Deoxycytidine - analogs & derivatives</subject><subject>Deoxycytidine - therapeutic use</subject><subject>Digestive system</subject><subject>Drug Resistance, Viral</subject><subject>Emtricitabine</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Guanine - analogs & derivatives</subject><subject>Guanine - therapeutic use</subject><subject>Hepatitis B virus</subject><subject>Hepatitis B virus - physiology</subject><subject>Hepatitis B, Chronic - diagnosis</subject><subject>Hepatitis B, Chronic - drug therapy</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Interferon-alpha - therapeutic use</subject><subject>Lamivudine - therapeutic use</subject><subject>Liver Cirrhosis - prevention & control</subject><subject>Medical sciences</subject><subject>Nucleosides - therapeutic use</subject><subject>Organophosphonates - therapeutic use</subject><subject>Pharmacology. Drug treatments</subject><subject>Polyethylene Glycols - therapeutic use</subject><subject>Pyrimidinones - therapeutic use</subject><subject>Recombinant Proteins</subject><subject>Reverse Transcriptase Inhibitors - therapeutic use</subject><subject>Tenofovir</subject><subject>Thymidine - analogs & derivatives</subject><subject>Viral diseases</subject><subject>Viral hepatitis</subject><subject>Virus Replication</subject><issn>0269-2813</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkFtLwzAUgIMobk7_guRF31pPLk1aQXAObzBQZD6HLEtZRtfOpLv9e1s35qOel3PgfOfChxAmEJMmbmYxYSKJKDARU4A0BiYZiTdHqHtoHKMuUJFFNCWsg85CmAGAkEBPUYekXAiWpF10_2FXzq6x9rUzhb3FZum9LWusy9qtnNcFrqfW68UWVzk2U1-VzuCpXeja1S7gh3N0kusi2It97qHPp8fR4CUavj2_DvrDyPCMkyjTkjIreG4oEWNtBNCxSAnhjBmbGwMMklTnkk3GmQTOE5o3fWkmNElkwiXroevd3oWvvpY21GrugrFFoUtbLYMSGQMpU_YnSDIBhEPWgOkONL4KwdtcLbyba79VBFSrWc1Ua1O1NlWrWf1oVptm9HJ_Yzme28nv4N5rA1ztAR2MLnKvS-PCgaPABeOZaLi7Hbd2hd3--wHVfx-1FfsGMBiWwA</recordid><startdate>200807</startdate><enddate>200807</enddate><creator>AYOUB, W. S.</creator><creator>KEEFFE, E. B.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>200807</creationdate><title>Review article: current antiviral therapy of chronic hepatitis B</title><author>AYOUB, W. S. ; KEEFFE, E. B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4941-9a723e64fc216bac602b6811433cefcc03058af73db9704452fb687cd25575473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adenine - analogs & derivatives</topic><topic>Adenine - therapeutic use</topic><topic>Antiviral Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Hepatocellular - prevention & control</topic><topic>Deoxycytidine - analogs & derivatives</topic><topic>Deoxycytidine - therapeutic use</topic><topic>Digestive system</topic><topic>Drug Resistance, Viral</topic><topic>Emtricitabine</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Guanine - analogs & derivatives</topic><topic>Guanine - therapeutic use</topic><topic>Hepatitis B virus</topic><topic>Hepatitis B virus - physiology</topic><topic>Hepatitis B, Chronic - diagnosis</topic><topic>Hepatitis B, Chronic - drug therapy</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Interferon-alpha - therapeutic use</topic><topic>Lamivudine - therapeutic use</topic><topic>Liver Cirrhosis - prevention & control</topic><topic>Medical sciences</topic><topic>Nucleosides - therapeutic use</topic><topic>Organophosphonates - therapeutic use</topic><topic>Pharmacology. Drug treatments</topic><topic>Polyethylene Glycols - therapeutic use</topic><topic>Pyrimidinones - therapeutic use</topic><topic>Recombinant Proteins</topic><topic>Reverse Transcriptase Inhibitors - therapeutic use</topic><topic>Tenofovir</topic><topic>Thymidine - analogs & derivatives</topic><topic>Viral diseases</topic><topic>Viral hepatitis</topic><topic>Virus Replication</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>AYOUB, W. S.</creatorcontrib><creatorcontrib>KEEFFE, E. B.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Alimentary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>AYOUB, W. S.</au><au>KEEFFE, E. B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Review article: current antiviral therapy of chronic hepatitis B</atitle><jtitle>Alimentary pharmacology & therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2008-07</date><risdate>2008</risdate><volume>28</volume><issue>2</issue><spage>167</spage><epage>177</epage><pages>167-177</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><abstract>Summary
Background The long‐term goals of therapy for chronic hepatitis B are to reduce serum HBV DNA to low or undetectable levels and ultimately reduce or prevent the development of cirrhosis and hepatocellular carcinoma.
Aim To review the current treatment of chronic hepatitis B, with a focus on diagnosis and management of resistance and active management of suboptimal responses.
Methods A systematic review of the literature, with a focus on recent guidelines, was undertaken.
Results Among the six drugs licensed for the treatment of chronic hepatitis B in the US, the preferred agents in 2008 will include entecavir, peginterferon alfa‐2a, possibly telbivudine, and tenofovir following licensure. When using an oral agent, a major focus of management is on the selection of a drug with high potency and low rate of resistance, and active on‐treatment management to optimize therapy. Preventing the sequelae of antiviral drug resistance and appropriate management when resistance is initially detected are also the major focus of current management. The addition of an antiviral agent that is not cross‐resistant is critical to restore suppression of viral replication.
Conclusions Newer agents and modified treatment strategies, especially using combination therapy, hold promise to optimize the management of patients with chronic hepatitis B by achieving the high potency and the lowest rate of resistance.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>18466358</pmid><doi>10.1111/j.1365-2036.2008.03731.x</doi><tpages>11</tpages></addata></record> |
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| subjects | Adenine - analogs & derivatives Adenine - therapeutic use Antiviral Agents - therapeutic use Biological and medical sciences Carcinoma, Hepatocellular - prevention & control Deoxycytidine - analogs & derivatives Deoxycytidine - therapeutic use Digestive system Drug Resistance, Viral Emtricitabine Gastroenterology. Liver. Pancreas. Abdomen Guanine - analogs & derivatives Guanine - therapeutic use Hepatitis B virus Hepatitis B virus - physiology Hepatitis B, Chronic - diagnosis Hepatitis B, Chronic - drug therapy Human viral diseases Humans Infectious diseases Interferon-alpha - therapeutic use Lamivudine - therapeutic use Liver Cirrhosis - prevention & control Medical sciences Nucleosides - therapeutic use Organophosphonates - therapeutic use Pharmacology. Drug treatments Polyethylene Glycols - therapeutic use Pyrimidinones - therapeutic use Recombinant Proteins Reverse Transcriptase Inhibitors - therapeutic use Tenofovir Thymidine - analogs & derivatives Viral diseases Viral hepatitis Virus Replication |
| title | Review article: current antiviral therapy of chronic hepatitis B |
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