title: [Current treatment of hepatitis B infection: where do the new nucleos(t)ide analogues fit in?].
abstract: One of the most important advances made in the treatment of chronic hepatitis B infection has been the development of nucleos(t)ide analogues. The first antiviral agents used had limited efficacy due to the high resistance rate. However, in the last few years, new agents (tenofovir, entecavir) have been developed with greater antiviral potency and a lower resistance rate. Consequently, these agents are considered to be the treatment of choice in the most recent clinical guidelines. Nevertheless, interferon may still play an important role in the treatment of hepatitis B in selected patients. Moreover, in some contexts, such as renal insufficiency, pregnancy or immunosuppression, the role of the new oral antiviral agents has not been precisely defined. The present review analyzes these aspects, as well as some of the particular features of the management of patients treated with nucleos(t)ide analogues.
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España. jfuentesolmo@sepd.es
authors.forename: Javier
authors.initials: J
authors.lastname: Fuentes Olmo
authors.forename: Rafael
authors.initials: R
authors.lastname: Uribarrena Amézaga
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives* / Q000737:chemistry / Q000627:therapeutic use; D000998:Antiviral Agents / Q000737:chemistry / Q000627:therapeutic use*; D015897:Comorbidity; D004359:Drug Therapy, Combination; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives* / Q000737:chemistry / Q000627:therapeutic use; D006509:Hepatitis B / Q000188:drug therapy*; D006515:Hepatitis B virus / Q000187:drug effects / Q000502:physiology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D019259:Lamivudine / Q000737:chemistry / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D015394:Molecular Structure; D009705:Nucleosides / Q000737:chemistry / Q000627:therapeutic use*; D009711:Nucleotides / Q000737:chemistry; D063065:Organophosphonates / Q000737:chemistry / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D011744:Pyrimidinones / Q000737:chemistry / Q000627:therapeutic use*; D051437:Renal Insufficiency / Q000150:complications; D000077712:Telbivudine; D000068698:Tenofovir; D013936:Thymidine / Q000031:analogs & derivatives; D014775:Virus Activation / Q000187:drug effects; D014779:Virus Replication / Q000187:drug effects
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D009705:Nucleosides; D009711:Nucleotides; D063065:Organophosphonates; D011744:Pyrimidinones; D000077712:Telbivudine; D019259:Lamivudine; C413685:entecavir; D006147:Guanine; C053001:adefovir; D000068698:Tenofovir; D000225:Adenine; D013936:Thymidine