[Antiviral treatment of chronic B hepatitis; 2010 - therapeutic recommendations].
The drugs currently approved for treatment of HBV infections are: interferon alpha2a and alpha2b, pegylated interferon (PeglFN-al-pha2a) natural interferons and nucleos(t)ide analogues (NA): adefovir, entecavir, lamivudine, telbivudine (currently not available in Poland) and tenofovir. The following questions are described: the primary goal of antiviral treatment, criteria in therapeutic decision-making (including extrahepatic manifestations, compensated and decompensated cirrhosis of the liver), treatment failure (including: drug resistance), management of patients with HBV-positive markers, in whom chemotherapy or other immunosuppressive therapy is planned. In treatment-naive patients with chronic hepatitis B the first line therapy should be PeglFN-alpha2a monotherapy, and the first-line should be entecavir or tenofovir (highest potential for HBV replication suppression and high genetic barrier to resistance). In drug resistance the patient should be switched to another, preferably high-potency NA (entecavir or tenofovir) or start PeglFN-alpha2a therapy.
Juszczyk
Jacek
J
juszczyk@post.pl
Boroń-Kaczmarska
Anna
A
Cianciara
Janusz
J
Flisiak
Robert
R
Gładysz
Andrzej
A
Halota
Waldemar
W
Kryczka
Wiesław
W
Malkowski
Piotr
P
Pawlowska
Małgorzata
M
Simon
Krzysztof
K
D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D024882:Drug Resistance, Viral; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D008099:Liver / Q000473:pathology; D063065:Organophosphonates / Q000627:therapeutic use; D011092:Polyethylene Glycols; D017410:Practice Guidelines as Topic; D011994:Recombinant Proteins; D000068698:Tenofovir; D017211:Treatment Failure; D019562:Viral Load
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D063065:Organophosphonates; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C413685:entecavir; D006147:Guanine; D000068698:Tenofovir; D000225:Adenine; C100416:peginterferon alfa-2a