CHSJ

Curr Health Sci J, vol. 36, no. 3, 2010

Updates on the Treatment of Chronical Hepatitis B

[Review]

A. LICAN(1), I.ROGOVEANU(1), T. CIUREA(1), L. SANDULESCU(1), D.COLDUSU(1), C. MISCU(1), N. BRAIA(1)


(1)Department of Internal Medicine, University of Medicine and Pharmacy, Emergency University Hospital, Craiova


Abstract:

Chronic infection with hepatitis B (HBV) is a major public health problem worldwide, with important socio-economic implications. It is estimated that over 2 billion people have been infected with HBV, of which 350-400 million chronic HBV carriers remain. Chronic HBV infection can lead to the development of liver cirrhosis and liver failure. Moreover, HBV is the most common cause of CHC and it is considered an oncogen virus. The goal of therapy in chronic viral hepatitis B is to improve patients` quality of life and increase survival by preventing progression to cirrhosis, liver cancer and death. Achieving the desired goal can be done through sustained serum HBV DNA suppression, which is accompanied by reducing the histological activity of chronic hepatitis and cirrhosis, leading to the decrease of risk of cancer. HBV infection can not be completely eradicated because of persistence of covalently circular DNA (cccDNA) in the nucleus of infected hepatocytes. But reducing viral load by treatment (studies with interferon or nucleoside analogues) have shown to reduce the risk of liver cancer. Treatment of chronic hepatitis B virus (HBV) is currently an exciting topic because of the progress in this direction. Controversy is tied primarily to the choice of first line treatment - pegylated interferon vs. nucleoside analogues / nucleotide, but also the best way to approach therapy of viral resistance development. There are data that argue the choice of pegylated interferon as initial therapy in patients with chronic viral hepatitis B, both in patients with HBe Ag positive and those with negative HBe Ag. On the other hand, nucleoside analogues (Lamivudine, Entecavir) and the nucleotide (Adefovir, tenofovir) have advantages that make them preferred in certain situations as initial treatment of chronic hepatitis patients with HBV.


Keywords: chronic viral hepatitis B, therapy, PEG-interferon alpha 2a, lamivudine, entecavir



Corresponding: Adina Lican , Md PhD stud. Department of Internal Medicine, University of Medicine and Pharmacy Craiova, Str Petru Rares nr. 4, 200456, Craiova, Dolj, Romania Dr_licanadina@yahoo.com


DOI 10.12865/CHSJ.36.03.01 - Download PDF
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