University of Calgary Liver Unit, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.
Expert Opin Pharmacother. 2013 Jul;14(10):1363-9. doi: 10.1517/14656566.2013.786701. Epub 2013 Apr 4.
Chronic hepatitis B (CHB) infection is common and carries a significant risk for the development of cirrhosis, hepatic decompensation, and hepatocellular carcinoma. The goal of treatment in patients with CHB-related decompensated cirrhosis is to improve hepatic dysfunction and reduce mortality through the inhibition of viral replication. Several studies have now shown nucleot(s)ide analogs to be safe and effective in decompensated cirrhosis due to CHB.
A review of the evidence for the use of entecavir in the treatment of decompensated hepatitis B cirrhosis is discussed.
Entecavir is an effective treatment option for most patients with CHB. In treatment naïve patients, it is a potent antiviral agent with a very low resistance rate, making it an excellent option for the treatment of decompensated hepatitis B cirrhosis. The use of entecavir monotherapy in patients with a known rtM204V lamivudine-resistant mutation should be avoided due to increased risk of developing entecavir resistance and failing treatment.
慢性乙型肝炎（CHB）感染很常见，会显著增加肝硬化、肝功能失代偿和肝细胞癌的风险。CHB 相关失代偿性肝硬化患者的治疗目标是通过抑制病毒复制来改善肝功能障碍并降低死亡率。由于 CHB 引起的失代偿性肝硬化，现在已有多项研究表明核苷酸类似物是安全有效的。
本文讨论了恩替卡韦治疗失代偿性乙型肝炎肝硬化的证据。
恩替卡韦是大多数 CHB 患者的有效治疗选择。对于初治患者，它是一种强效抗病毒药物，耐药率非常低，因此是治疗失代偿性乙型肝炎肝硬化的绝佳选择。对于已知存在 rtM204V 拉米夫定耐药突变的患者，应避免使用恩替卡韦单药治疗，因为这会增加发生恩替卡韦耐药和治疗失败的风险。
