Lai Cindy J, Terrault Norah A
Division of General Internal Medicine, University of California San Francisco, S357, 513 Parnassus Avenue, San Francisco, CA 94143-0538, USA.
Gastroenterol Clin North Am. 2004 Sep;33(3):629-54, x-xi. doi: 10.1016/j.gtc.2004.05.002.
Chronic hepatitis B virus infection (HBV) may result in significant morbidity, including cirrhosis, end-stage liver disease, and hepatocellular carcinoma. The management of chronic HBV cirrhosis is advancing rapidly. Current treatment options for patients with HBV-related cirrhosis include interferon-alpha (IFN-alpha), lamivudine and adefovir dipivoxil. IFN-a is used less commonly today because of its toxicity, difficulty with administration, and the availability of safer drugs. Lamivudine, an oral nucleoside analog, has proven to be at least as effective, and is safer, than IFN-a in the treatment of HBV-related cirrhosis. It is plagued by the development of resistant viral mutants, however. The newest oral nucleotide analog, adefovir dipivoxil, has shown excellent efficacy in treatment-naïve and lamivudine-resistant HBV patients and has lower rates of resistance in the short-term.
慢性乙型肝炎病毒感染（HBV）可能导致严重的发病情况，包括肝硬化、终末期肝病和肝细胞癌。慢性HBV肝硬化的治疗进展迅速。目前针对HBV相关肝硬化患者的治疗选择包括α干扰素（IFN-α）、拉米夫定和阿德福韦酯。如今，由于其毒性、给药困难以及更安全药物的出现，IFN-α的使用较少。拉米夫定是一种口服核苷类似物，已被证明在治疗HBV相关肝硬化方面至少与IFN-α一样有效，且更安全。然而，它受到耐药病毒突变体产生的困扰。最新的口服核苷酸类似物阿德福韦酯在初治和拉米夫定耐药的HBV患者中显示出优异的疗效，且短期内耐药率较低。
