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Management of Antiviral Resistance in Chronic Hepatitis B
Gut and Liver ; : 189-195, 2017.
Artigo em Inglês | WPRIM | ID: wpr-194970
ABSTRACT
The primary goal of therapy for chronic hepatitis B (CHB) is to prevent liver disease progression. Hepatitis B surface antigen (HBsAg) seroclearance or seroconversion is regarded as an optimal endpoint to discontinue treatment. However, HBsAg seroclearance occurs very rarely with nucleos(t)ide analog (NUC) treatment, and long-term, almost indefinite, NUC treatment is required for the majority of patients. In patients with drug-resistant hepatitis B virus (HBV), a combination of tenofovir disoproxil fumarate (TDF) and entecavir (ETV), which is currently regarded as the strongest combination therapy against HBV, would be potentially safe to prevent the emergence of additional HBV resistance mutations. However, long-term tolerance data are lacking, and cost may be an issue for combination therapies. Several recent, well-designed, randomized controlled trials have shown that TDF mono-therapy provides similar antiviral efficacy compared with the combination of TDF and ETV. Furthermore, no additional HBV resistance mutations emerged during TDF monotherapy for up to 96 weeks. Considering a comparable antiviral efficacy, extremely low risk of TDF-resistance, lower cost, and better safety potential, TDF monotherapy would be a reasonable choice for the treatment of drug-resistant patients with CHB.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Vírus da Hepatite B / Lamivudina / Hepatite B Crônica / Tenofovir / Soroconversão / Antígenos de Superfície da Hepatite B / Hepatite Crônica / Hepatopatias Tipo de estudo: Ensaio Clínico Controlado Limite: Humanos Idioma: Inglês Revista: Gut and Liver Ano de publicação: 2017 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Vírus da Hepatite B / Lamivudina / Hepatite B Crônica / Tenofovir / Soroconversão / Antígenos de Superfície da Hepatite B / Hepatite Crônica / Hepatopatias Tipo de estudo: Ensaio Clínico Controlado Limite: Humanos Idioma: Inglês Revista: Gut and Liver Ano de publicação: 2017 Tipo de documento: Artigo