Treatment of chronic hepatitis B with nucleos(t)ide analogues

Recently antiviral therapies for chronic hepatitis B using nucleos(t)ide analogues have become standard treatment modalities on the basis of several independent guidelines, starting with those of the American Association for the Study of Liver Diseases (AASLD) and other such organizations and bodies...

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Bibliographic Details
Published in:Hepatology research 2012-03, Vol.42 (3), p.219-225
Main Authors: Ohishi, Waka, Chayama, Kazuaki
Format: Article
Language:English
Subjects:
Adefovir
Alanine transaminase
DNA
Drug resistance
drug-resistant virus
HBV core-related antigen
HBV DNA
HBV genotype
Head
hepatitis B e antigen
Hepatitis B virus
interferon
Lamivudine
Liver diseases
nucleos(t)ide analogue
Philosophy
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Summary:Recently antiviral therapies for chronic hepatitis B using nucleos(t)ide analogues have become standard treatment modalities on the basis of several independent guidelines, starting with those of the American Association for the Study of Liver Diseases (AASLD) and other such organizations and bodies, including the European Association for the Study of the Liver (EASL), the Asian Pacific Association for the Study of the Liver (APASL), and the Japanese Ministry of Health, Labour and Welfare (MHLW)'s research team. The philosophies underlying such treatment strategies are considered basically equivalent. MHLW's guidelines define subjects for medical intervention to be cases measuring alanine aminotransferase (ALT) ≥31 IU/L, with serological hepatitis B virus (HBV) DNA level ≥5 log copies/mL for hepatitis B e antigen (HBeAg)‐positive cases, and serological HBV DNA level ≥4 log copies/mL for HBeAg‐negative cases. These Japanese guidelines advocate entecavir as the first‐line treatment option for nucleos(t)ide‐naïve patients, and combination treatment of lamivudine and adefovir as the basis of treatment for patients with lamivudine‐ and/or entecavir‐resistant viruses. Of particular note for patients undergoing lamivudine treatment with persistent HBV DNA level 
ISSN:1386-6346
1872-034X
DOI:10.1111/j.1872-034X.2011.00921.x