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A Competent Hepatocyte Model Examining Hepatitis B Virus Entry through Sodium Taurocholate Cotransporting Polypeptide as a Therapeutic Target
Published on: May 10, 2022
Chronic hepatitis B--treatment with nucleoside analogues
1Alice Ho Miu Ling Nethersole Hospital and The Chinese University of Hong Kong, Hong Kong, SAR, China.
The Medical Journal of Malaysia
|August 20, 2005
Summary
Nucleoside analogues like lamivudine, adefovir dipivoxil, and entecavir offer safe oral treatments for chronic hepatitis B. While effective, resistance and durability of response require careful patient counseling and risk-benefit assessment.
Area of Science:
- Hepatology
- Virology
- Pharmacology
Background:
- Nucleos(t)ide analogues represent significant advancements in treating chronic hepatitis B (CHB) with oral therapies.
- Lamivudine, adefovir dipivoxil, and entecavir have been FDA-approved for CHB treatment.
Purpose of the Study:
- To review the efficacy and safety of nucleos(t)ide analogues in chronic hepatitis B treatment.
- To discuss the emergence of drug resistance and durability of response with these therapies.
Main Methods:
- Review of FDA-approved nucleos(t)ide analogue therapies for CHB.
- Analysis of efficacy data regarding viral suppression, ALT normalization, and histological improvement.
- Evaluation of safety profiles, including adverse events and drug resistance patterns.
Main Results:
- Lamivudine demonstrates efficacy but is associated with 15-20% annual YMDD mutant resistance and variable durability.
- Adefovir dipivoxil shows good tolerability and lower resistance rates (18% after 4 years), with rare renal toxicity.
- Entecavir is potent, with resistance primarily observed in lamivudine-refractory patients.
Conclusions:
- Nucleos(t)ide analogues are effective for CHB, but resistance and long-term durability vary.
- Careful patient counseling is crucial for selecting the optimal therapy based on individual risk-benefit assessments.
- Understanding resistance profiles and long-term outcomes is essential for managing chronic hepatitis B.
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