Nucleos(t)ide analogues for hepatitis B virus: strategies for long-term success.

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Chien RN, Liaw YF

Nucleos(t)ide analogues for hepatitis B virus: strategies for long-term success.

Best Pract Res Clin Gastroenterol. 2008;22(6):1081-92. doi: 10.1016/j.bpg.2008.11.003.

PubMed ID

19187868 [ View in PubMed

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Abstract

Studies in the past decades have shown that active hepatitis B virus (HBV) replication is the key driver of liver injury and disease progression, and thus sustained viral suppression is of paramount importance in the management of chronic HBV infection. The nucleos(t)ide analogues lamivudine, adefovir, entecavir, telbivudine and tenofovir are potent inhibitors of HBV polymerase/reverse transcriptase activity and are highly effective in the suppression of HBV replication, but rarely eliminate the virus. Long-term therapy is usually required to achieve sustained hepatitis B e antigen seroconversion, HBV DNA suppression, ALT normalization and fibrosis reversal. Maintained long-term therapy has been demonstrated to significantly lower the rate of hepatic decompensation and development of cirrhosis or hepatocellular carcinoma. However, drug resistance is a serious risk on prolonged nucleos(t)ide analogue therapy, and this poses a critical challenge. Prevention and proper management of drug resistance are crucial to ensure long-term success.

DrugBank Data that Cites this Article

Drug Targets

Drug	Target	Kind	Organism	Pharmacological Action	Actions
Adefovir dipivoxil	DNA polymerase/reverse transcriptase	Protein	HBV-D	Yes	Other	Details