Brunetto Maurizia R, Lok Anna S
Hepatology Unit, University Hospital of Pisa, Pisa, Italy.
Antivir Ther. 2010;15 Suppl 3:61-8. doi: 10.3851/IMP1625.
Substantial advances have been made in the treatment of chronic hepatitis B in the past decade. Currently, there are seven approved agents including two forms of interferon (conventional and pegylated), and five oral nucleoside/nucleotide analogues (lamivudine, adefovir, entecavir, telbivudine and tenofovir disoproxil fumarate). The availability of these multiple treatment options has led to expansion of treatment indications. However, the need for a long duration of treatment with some therapies, the high costs of HBV medications, the side effects associated with some treatments and the risks of drug resistance during long-term use of oral antiviral medications necessitate the careful assessment of the risk-benefit ratio prior to initiating treatment, and the evaluation of better strategies to optimize response once treatment is initiated. In this article, we review the current approaches to optimize treatment response to nucleoside/nucleotide analogue- and interferon-based therapies for chronic hepatitis B.
在过去十年中，慢性乙型肝炎的治疗取得了重大进展。目前，有七种获批药物，包括两种形式的干扰素（普通干扰素和聚乙二醇化干扰素）以及五种口服核苷/核苷酸类似物（拉米夫定、阿德福韦、恩替卡韦、替比夫定和富马酸替诺福韦二吡呋酯）。这些多种治疗选择的出现导致了治疗适应证的扩大。然而，一些疗法需要长期治疗，乙肝药物成本高昂，某些治疗存在副作用，以及口服抗病毒药物长期使用期间出现耐药性的风险，这就需要在开始治疗前仔细评估风险效益比，并在开始治疗后评估优化疗效的更好策略。在本文中，我们综述了目前优化慢性乙型肝炎基于核苷/核苷酸类似物和干扰素疗法疗效的方法。
