Fuentes Olmo Javier, Uribarrena Amézaga Rafael
Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España.
Gastroenterol Hepatol. 2011 Aug-Sep;34(7):492-503. doi: 10.1016/j.gastrohep.2011.02.009. Epub 2011 May 6.
One of the most important advances made in the treatment of chronic hepatitis B infection has been the development of nucleos(t)ide analogues. The first antiviral agents used had limited efficacy due to the high resistance rate. However, in the last few years, new agents (tenofovir, entecavir) have been developed with greater antiviral potency and a lower resistance rate. Consequently, these agents are considered to be the treatment of choice in the most recent clinical guidelines. Nevertheless, interferon may still play an important role in the treatment of hepatitis B in selected patients. Moreover, in some contexts, such as renal insufficiency, pregnancy or immunosuppression, the role of the new oral antiviral agents has not been precisely defined. The present review analyzes these aspects, as well as some of the particular features of the management of patients treated with nucleos(t)ide analogues.
慢性乙型肝炎感染治疗方面取得的最重要进展之一是核苷（酸）类似物的研发。由于高耐药率，最初使用的抗病毒药物疗效有限。然而，在过去几年中，已研发出具有更高抗病毒效力和更低耐药率的新型药物（替诺福韦、恩替卡韦）。因此，这些药物在最新的临床指南中被视为首选治疗药物。尽管如此，干扰素在部分特定患者的乙肝治疗中可能仍发挥重要作用。此外，在某些情况下，如肾功能不全、妊娠或免疫抑制，新型口服抗病毒药物的作用尚未明确界定。本综述分析了这些方面，以及接受核苷（酸）类似物治疗患者管理的一些特殊特征。
