[Antiviral treatment of chronic B hepatitis; 2010 - therapeutic recommendations]

Pol Merkur Lekarski. 2010 Aug;29(170):103-6.
[Article in Polish]

Abstract

The drugs currently approved for treatment of HBV infections are: interferon alpha2a and alpha2b, pegylated interferon (PeglFN-al-pha2a) natural interferons and nucleos(t)ide analogues (NA): adefovir, entecavir, lamivudine, telbivudine (currently not available in Poland) and tenofovir. The following questions are described: the primary goal of antiviral treatment, criteria in therapeutic decision-making (including extrahepatic manifestations, compensated and decompensated cirrhosis of the liver), treatment failure (including: drug resistance), management of patients with HBV-positive markers, in whom chemotherapy or other immunosuppressive therapy is planned. In treatment-naive patients with chronic hepatitis B the first line therapy should be PeglFN-alpha2a monotherapy, and the first-line should be entecavir or tenofovir (highest potential for HBV replication suppression and high genetic barrier to resistance). In drug resistance the patient should be switched to another, preferably high-potency NA (entecavir or tenofovir) or start PeglFN-alpha2a therapy.

MeSH terms

  • Adenine / analogs & derivatives
  • Adenine / therapeutic use
  • Antiviral Agents / therapeutic use*
  • Drug Administration Schedule
  • Drug Resistance, Viral
  • Guanine / analogs & derivatives
  • Guanine / therapeutic use
  • Hepatitis B, Chronic / drug therapy*
  • Hepatitis B, Chronic / pathology
  • Humans
  • Interferon alpha-2
  • Interferon-alpha
  • Liver / pathology
  • Organophosphonates / therapeutic use
  • Polyethylene Glycols
  • Practice Guidelines as Topic*
  • Recombinant Proteins
  • Tenofovir
  • Treatment Failure
  • Viral Load

Substances

  • Antiviral Agents
  • Interferon alpha-2
  • Interferon-alpha
  • Organophosphonates
  • Recombinant Proteins
  • Polyethylene Glycols
  • entecavir
  • Guanine
  • Tenofovir
  • Adenine
  • peginterferon alfa-2a