[Chronic hepatitis B: current therapy].
HBV cannot be fully eradicated from the body because of the persistence of covalently closed circular DNA (cccDNA) in the nucleus of infected hepatocytes. True cure is infrequent, but persistent suppression of HBV DNA slows liver disease progression and helps to prevent hepatocellular carcinoma. Treatment options for chronic hepatitis B include pegylated interferon and 4 licensed oral nucleosides/nucleotides (lamivudine, adefovir entecavir and tenofovir). Interferon is the only drug with a defined duration of treatment. It is effective in 30% to 40% of patients but is poorly tolerated. In contrast to interferon, nucleotide/nucleoside analogs have only minor adverse effects. However, a resurgence of the infection may occur when these drugs are withdrawn, implying that treatment may have to continue indefinitely. The onset of viral resistance to these agents also limits their long-term use but can be minimized by ensuring potent suppression of viral replication.
Buffet
Catherine
C
Hépatogastroentérologie, Hôpital de Bicêtre, 78, rue du Général Leclerc, 94270 Kremlin-Bicetre. catherine.buffet@bct.ap-hop-paris.fr
D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000517:prevention & control / Q000821:virology; D018450:Disease Progression; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D017325:Hepatitis B Vaccines / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000187:drug effects; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000453:epidemiology / Q000628:therapy; D022781:Hepatocytes / Q000821:virology; D006801:Humans; D016233:Immunotherapy, Active; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000517:prevention & control / Q000821:virology; D063065:Organophosphonates / Q000627:therapeutic use; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011994:Recombinant Proteins; D000068698:Tenofovir; D016896:Treatment Outcome
D000998:Antiviral Agents; D017325:Hepatitis B Vaccines; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D063065:Organophosphonates; D011994:Recombinant Proteins; D019259:Lamivudine; D011092:Polyethylene Glycols; C413685:entecavir; D006147:Guanine; C053001:adefovir; D000068698:Tenofovir; C417083:peginterferon alfa-2b; D000225:Adenine; C100416:peginterferon alfa-2a