title: Management of antiviral drug resistance in chronic hepatitis B.
abstract: Rescue antiviral treatment for patients with resistance to preexisting nucleos(t)ide analogues remains a clinical challenge. The correct choice of a first-line treatment of high potency and with a high genetic barrier to achieve sustained long-term suppression of viral replication provides the best chance of preventing treatment failure and the emergence of drug resistance. The management of treatment failure and drug resistance requires a precise and accurate clinical and virologic monitoring. Combination treatment with antiviral drugs that belong to different groups is associated with a lower chance of developing resistance to rescue drugs. To guarantee better control of viral replication in patients with drug resistance, the addition of another drug without a cross resistance profile should be given as early as possible, preferably at the time when genotypic resistance emerges. Long-term surveillance for treatment efficacy and possible emergence of drug resistance should be continued to prevent the emergence of multidrug-resistant strains.
authors.affiliation: Ki Bae Bang, Hong Joo Kim, Department of Internal Medicine, Sungkyunkwan University Kangbuk Samsung Hospital, Seoul 110-746, South Korea.
authors.forename: Ki Bae
authors.initials: KB
authors.lastname: Bang
authors.affiliation: Ki Bae Bang, Hong Joo Kim, Department of Internal Medicine, Sungkyunkwan University Kangbuk Samsung Hospital, Seoul 110-746, South Korea.
authors.forename: Hong Joo
authors.initials: HJ
authors.lastname: Kim
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D024921:Drug Resistance, Multiple, Viral; D024882:Drug Resistance, Viral / Q000235:genetics; D005838:Genotype; D006515:Hepatitis B virus / Q000187:drug effects* / Q000235:genetics / Q000254:growth & development / Q000472:pathogenicity; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D017211:Treatment Failure; D014779:Virus Replication / Q000187:drug effects
chemical_list: D000998:Antiviral Agents
keywords: Antiviral resistance; Chronic hepatitis B; Cross resistance; Multidrug resistance; Rescue treatment