Zoulim Fabien
INSERM, U871, 151 cours Albert Thomas, 69424 Lyon cedex 03, France.
Expert Opin Emerg Drugs. 2007 May;12(2):199-217. doi: 10.1517/14728214.12.2.199.
Chronic hepatitis B remains a treatment challenge despite the availability of new nucleoside analogs. This is due to the persistence of viral infection during therapy, which exposes the patient to the risk of developing antiviral drug resistance. Therefore, new polymerase inhibitors are needed to manage resistance to existing drugs and new trials of combination therapy are required to delay drug resistance. In the future, antiviral agents targeting other steps of the viral life cycle will be needed to achieve antiviral synergy and prevent antiviral drug resistance. Immune modulators are also expected to enhance antiviral response and to achieve sustained response. Discovery of new antiviral drugs and design of new treatment strategies are, therefore, needed to manage this disease, which is still the main cause of cirrhosis and hepatocellular carcinoma worldwide.
尽管有新型核苷类似物可供使用,但慢性乙型肝炎仍然是一个治疗难题。这是由于治疗期间病毒感染持续存在,使患者面临产生抗病毒药物耐药性的风险。因此,需要新的聚合酶抑制剂来应对对现有药物的耐药性,并且需要进行联合治疗的新试验来延缓耐药性。未来,将需要针对病毒生命周期其他步骤的抗病毒药物来实现抗病毒协同作用并防止抗病毒药物耐药性。免疫调节剂也有望增强抗病毒反应并实现持续反应。因此,需要发现新的抗病毒药物并设计新的治疗策略来管理这种疾病,它仍是全球肝硬化和肝细胞癌的主要病因。