title: Recent Advances in the Management of Chronic Hepatitis B Including Suppression of Hepatocellular Carcinoma by Entecavir and Interferon.
abstract: At present, for adults with chronic hepatitis B virus (HBV) infection, two new analogues, entecavir (ETV) and tenofovir, are recommended as the first-line therapy by the EASL (European Association for the Study of the Liver), AASLD (American Association for the Study of Liver Diseases), and APASL (Asian Pacific Association for the Study of the Liver) guidelines. The use of pegylated interferon-α (PEG IFN-α) is recommended as the first-line therapy instead of standard IFN-α according to the above 3 guidelines. In this paper, the aim was to assess: (1) the long-term efficacy and safety as well as the resistance to ETV and tenofovir disoproxil fumarate (TDF); (2) the efficacy of PEG IFN-α; (3) the role of combination therapy with IFN plus two analogues, such as lamivudine and ETV; (4) the efficacy and safety of two analogues with cirrhosis, and (5) suppression of hepatocellular carcinoma (HCC) by ETV and IFN treatment. The results are as follows: (1) both ETV and TDF showed long-term efficacy and safety; (2) PEG IFN-α resulted in a greater decline in HBV DNA levels and a higher rate of HBeAg seroconversion; (3) combination therapy with IFN plus two analogues did not elevate the rate of sustained responses; (4) both ETV and TDF showed efficacy and safety with cirrhosis (ETV especially displayed efficacy and safety with decompensated cirrhosis), and (5) suppression of HCC was observed by ETV and IFN.
authors.affiliation: Department of Gastroenterology and Hepatology, Kyoto University, Kyoto, Japan.
authors.forename: Soo Ki
authors.initials: SK
authors.lastname: Kim
authors.forename: Soo Ryang
authors.initials: SR
authors.lastname: Kim
authors.forename: Susumu
authors.initials: S
authors.lastname: Imoto
authors.forename: Madoka
authors.initials: M
authors.lastname: Tohyama
authors.forename: Yumi
authors.initials: Y
authors.lastname: Otono
authors.forename: Tomoko
authors.initials: T
authors.lastname: Tamura
authors.forename: Ke Ih
authors.initials: KI
authors.lastname: Kim
authors.forename: Mana
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Aya
authors.initials: A
authors.lastname: Ohtani
authors.forename: Kayo
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Aya
authors.initials: A
authors.lastname: Mizuguchi
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Hiramatsu
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D002986:Clinical Trials as Topic; D019468:Disease Management; D004359:Drug Therapy, Combination; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D007564:Japan / Q000453:epidemiology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D017410:Practice Guidelines as Topic; D011379:Prognosis
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; C413685:entecavir; D006147:Guanine