title: Antiviral Therapy in Hepatitis B Virus-Associated Liver Cirrhosis.
abstract: BACKGROUND
  Chronic hepatitis B virus (HBV) infection is a major risk factor for the development of liver cirrhosis and hepatocellular carcinoma (HCC). Key Messages: In patients with advanced liver fibrosis or liver cirrhosis, antiviral therapy is mandatory to slow down, halt or reverse disease progression and possibly reduce the risk of HCC development. As in patients without advanced fibrosis, PEG-interferon and nucleoside/nucleotide analogues (NUCs) are available for antiviral therapy. NUC therapy should be performed indefinitely as the rates of HBs-Ag loss are low. Entecavir or tenofovir should be preferred due to their strong antiviral potency and their high barrier to resistance. PEG-interferon therapy can be administered to patients with compensated liver disease but should not be offered to patients with signs of hepatic decompensation.
  
  
  CONCLUSIONS
  Antiviral therapy in chronic HBV infection can reduce liver fibrosis and even revert overt cirrhosis. Whether it also reduces the risk of HCC development in cirrhotic patients remains elusive and might vary in different countries and ethnicities.
authors.affiliation: Clinic for Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Freiburg, Freiburg, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Boettler
authors.forename: Robert
authors.initials: R
authors.lastname: Thimme
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000473:pathology / Q000821:virology; D018450:Disease Progression; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D019259:Lamivudine / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D008113:Liver Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000821:virology; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D000068698:Tenofovir / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D006513:Hepatitis B e Antigens; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D011092:Polyethylene Glycols; C413685:entecavir; D006147:Guanine; D000068698:Tenofovir; C417083:peginterferon alfa-2b