title: Optimal management of chronic hepatitis B patients with treatment failure and antiviral drug resistance.
abstract: The management of treatment failure in patients with chronic hepatitis B, remains a clinical concern. Incomplete viral suppression and the emergence of drug resistance are key determinants of treatment failure. The correct choice of a potent first-line therapy to achieve sustained long-term suppression of viral replication provides the best chance of preventing treatment failure and drug resistance. Clinical studies have demonstrated that drugs with a high barrier to resistance have significantly lower rates of resistance compared with those with a low barrier to resistance. Management of treatment failure requires precise clinical and virological monitoring as well as early treatment intervention with appropriate noncross-resistant antivirals. Long-term surveillance of treatment efficacy and possible emergence of drug resistance is necessary in patients who have been sequentially treated with multiple antivirals. The identification of novel treatment targets remains a major research goal to improve the efficacy of current antiviral therapy through combination therapy regimens.
authors.affiliation: INSERM, U1052, Cancer Research Center of Lyon, Lyon University, Lyon, France. fabien.zoulim@inserm.fr
authors.forename: Fabien
authors.initials: F
authors.lastname: Zoulim
authors.forename: Stephen
authors.initials: S
authors.lastname: Locarnini
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D024882:Drug Resistance, Viral / Q000235:genetics; D004359:Drug Therapy, Combination; D005838:Genotype; D006515:Hepatitis B virus / Q000187:drug effects / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D010641:Phenotype; D013997:Time Factors; D017211:Treatment Failure
chemical_list: D000998:Antiviral Agents