[Chronic hepatitis B: antiviral treatment guidelines].
The main goals of chronic hepatitis B therapy are, sustained reduction of HBV DNA below the limit of detection of real-time PCR (10-15 IU/mL), biochemical remission (ALT normalization) and histological improvement, in order to prevent disease progression associated with cirrhosis and hepatocellular carcinoma. In HBeAg positive patients, the objective is to achieve durable HBe seroconversion and/or in all patients lost of HBsAg, with or without anti-HBs seroconversion. Antiviral treatment is recommended in patients with HBV DNA levels above 2000 IU/ml and/or elevated ALT values and histological findings in liver biopsy over A1F1. The treatment may be a first line of pegylated interferon for 48 weeks in patients who have factors related to virological response. The other strategy is based on long-term administration of a nucleos (t) ide analogue with a potent antiviral activity and good patterns of resistance and safety (entecavir or tenofovir).
Hézode
Christophe
C
Service d'hépatologie et de gastroentérologie, hôpital Henri-Mondor, AP-HP, université Paris 12, 94000 Créteil. christophe.hezode@hmn.aphp.fr
Pawlotsky
Jean-Michel
JM
D000465:Algorithms; D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans
D000998:Antiviral Agents