den Eynde Eva Van, Riveiro-Barciela Mar
Unidad VIH, Servicio de Enfermedades Infecciosas, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
Servicio de Hepatología-Medicina Interna, Hospital Universitari Vall d'Hebron, Barcelona, España.
Enferm Infecc Microbiol Clin. 2016 Jul;34 Suppl 3:47-51. doi: 10.1016/S0213-005X(16)30219-1.
Chronic hepatitis B is a major cause of morbidity and mortality worldwide. Approximately one third of the world's population has serological evidence of past or present infection by hepatitis B virus (HBV) and 350-400 million people are chronic HBV surface antigen carriers. The aim of therapy is to prevent the onset of liver fibrosis and development of cirrhosis or hepatocarcinoma by sustained suppression of viral replication. Currently there are 2 strategies for the treatment of chronic hepatitis B: the pegylated interferon and long-term treatment with nucleoside/nucleotide analogues. Pegylated interferon has the advantage of being a treatment of limited duration, and is particularly suitable for patients with chronic hepatitis with positive HBeAg (hepatitis B e antigen), but the unfavorable adverse event profile and route of parenteral administration makes it less used than nucleoside/nucleotide analogues. Tenofovir and entecavir have shown to be potent inhibitors of HBV with a high genetic barrier to resistance and few adverse effects, so are considered as the first line therapy.
慢性乙型肝炎是全球发病和死亡的主要原因。世界上约三分之一的人口有过去或现在感染乙型肝炎病毒（HBV）的血清学证据，3.5亿至4亿人是慢性HBV表面抗原携带者。治疗的目的是通过持续抑制病毒复制来预防肝纤维化的发生以及肝硬化或肝癌的发展。目前治疗慢性乙型肝炎有两种策略：聚乙二醇化干扰素和核苷/核苷酸类似物长期治疗。聚乙二醇化干扰素有治疗疗程有限的优点，特别适用于HBeAg（乙肝e抗原）阳性的慢性肝炎患者，但不良事件较多且为胃肠外给药途径，使其使用不如核苷/核苷酸类似物广泛。替诺福韦和恩替卡韦已被证明是有效的HBV抑制剂，对耐药具有高遗传屏障且不良反应少，因此被视为一线治疗药物。
