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Antiviral therapy in patients with chronic hepatitis B and cirrhosis

Cindy J Lai1, Norah A Terrault

  • 1Division of General Internal Medicine, University of California San Francisco, S357, 513 Parnassus Avenue, San Francisco, CA 94143-0538, USA.

Gastroenterology Clinics of North America
|August 25, 2004
PubMed

Insights

Hepatitis B virus (HBV) cirrhosis management is evolving. Adefovir dipivoxil offers effective treatment for treatment-naïve and lamivudine-resistant patients with lower short-term resistance rates.

Area of Science:

  • Hepatology
  • Virology
  • Pharmacology

Background:

  • Chronic hepatitis B virus (HBV) infection can lead to severe liver disease, including cirrhosis, end-stage liver disease, and hepatocellular carcinoma.
  • Management of chronic HBV cirrhosis is a rapidly advancing field.
  • Current treatments include interferon-alpha (IFN-alpha), lamivudine, and adefovir dipivoxil.

Purpose of the Study:

  • To review current treatment options for HBV-related cirrhosis.
  • To compare the efficacy and safety of available therapies.
  • To highlight the emergence of new agents like adefovir dipivoxil.

Main Methods:

  • Review of existing literature on HBV cirrhosis treatments.
  • Comparison of clinical outcomes and resistance profiles of IFN-alpha, lamivudine, and adefovir dipivoxil.
  • Analysis of drug toxicity and administration challenges.

Main Results:

  • Interferon-alpha (IFN-alpha) is less frequently used due to toxicity and administration issues.
  • Lamivudine, an oral nucleoside analog, is safer and as effective as IFN-alpha but is associated with viral resistance.
  • Adefovir dipivoxil, a newer oral nucleotide analog, demonstrates excellent efficacy in treatment-naïve and lamivudine-resistant HBV patients with lower short-term resistance.

Conclusions:

  • Adefovir dipivoxil represents a significant advancement in treating HBV-related cirrhosis.
  • The drug offers a promising alternative with a favorable resistance profile.
  • Ongoing research is crucial for managing HBV-related liver disease progression.

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