[The efficacy of adefovir dipivoxil, entecavir and telbivudine for chronic hepatitis B treatment: a systematic review].
BACKGROUND
Chronic hepatitis B is one of the most frequent infectious disease in the world and represents a serious problem of public health


METHODS
A systematic review of randomized clinical trials was conducted to evaluate the efficacy of the nucleoside/nucleotide analogues (adefovir, entecavir and telbivudine) used for the treatment of chronic hepatitis B. The databases PubMed and LILACS were consulted, among others


RESULTS
Twenty nine articles published between January/1970 to December/2009 were selected


CONCLUSIONS
All nucleoside/nucleotide analogues demonstrate upper or similar efficacy to lamivudine. The entecavir can be appropriate for patients with chronic hepatitis B, HBeAg positive and negative treatment-naive as alternative to lamivudine, considering its low potential of viral resistance. The addition of adefovir to lamivudine presented good results in lamivudine resistant patients. The use of entecavir and telbivudine in those patients presents risk of crossed resistance. TBV is one of the most recent antivirals available, but antiviral resistance already documented represents limitation to its use as therapeutic option to LAM. Adverse events of nucleoside/nucleotide analogues were similar in characteristics, gravity and incidence when compared to the lamivudina and placebo.
Almeida
Alessandra Maciel
AM
Programa de Pós-Graduação em Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, MG.
Ribeiro
Andréia Queiroz
AQ
Pádua
Cristiane Aparecida Menezes de
CA
Brandão
Cristina Mariano Ruas
CM
Andrade
Eli Iôla Gurgel
EI
Cherchiglia
Mariângela Leal
ML
Carmo
Ricardo Andrade
RA
Acurcio
Francisco de Assis
Fde A
D000225:Adenine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D009705:Nucleosides / Q000627:therapeutic use*; D063065:Organophosphonates / Q000627:therapeutic use*; D011744:Pyrimidinones / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D000077712:Telbivudine; D013936:Thymidine / Q000031:analogs & derivatives; D016896:Treatment Outcome
D000998:Antiviral Agents; D009705:Nucleosides; D063065:Organophosphonates; D011744:Pyrimidinones; D000077712:Telbivudine; C413685:entecavir; D006147:Guanine; D000225:Adenine; C106812:adefovir dipivoxil; D013936:Thymidine