title: Use of entecavir for the treatment of complex forms of hepatitis B.
abstract: BACKGROUND
  Although most HBV infections are effectively managed by the available therapies, the treatment of the most complex cases of hepatitis B still represents an unmet medical need. Entecavir is considered a first-line therapeutic option for hepatitis B, due to its demonstrated efficacy in rapidly suppressing the viral load. Its activity is also characterized by a high genetic barrier and an overall favorable safety profile.
  
  
  OBJECTIVE
  This review provides an overview of the most recent evidence related to the use of entecavir in the management of the most complex forms of hepatitis B.
  
  
  METHODS
  Original articles for inclusion in this review were retrieved from online databases such as PubMed/Medline and EMBASE; their reference list was browsed to found other relevant papers. The identified papers were selected for inclusion in the present manuscript according to their relevance for the topic. The search was last updated on December 2013.
  
  
  RESULTS
  Several studies have proven the efficacy and safety of entecavir in the treatment of patients affected by complex forms of hepatitis B, as those with decompensated cirrhosis, exacerbations of HBV infection and fulminant hepatic failure or in transplanted subjects.
  
  
  CONCLUSIONS
  Overall, entecavir seems a powerful therapeutic strategy for the treatment of HBV infection, even in patients affected by the most complex forms of hepatitis. The high efficacy of entecavir, associated with its safety profile, its high genetic barrier to resistance and its cost-effectiveness, allowed this molecule to become one of the preferred first-line options of treatment to manage HBV infections. However, further researches and trials are still needed to definitively elucidate its effectiveness in the daily clinical practice.
authors.affiliation: Department of Gastroenterology, Pisa University Hospital, Pisa, Italy. r.sacco@ao-pisa.toscana.it.
authors.forename: R
authors.initials: R
authors.lastname: Sacco
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D024882:Drug Resistance, Viral; D005838:Genotype; D006147:Guanine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics; D006515:Hepatitis B virus / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; C413685:entecavir; D006147:Guanine