Considerations for the long-term treatment of chronic hepatitis B with nucleos(t)ide analogs.

Maria Buti, Jörg Petersen

Journal: Expert review of gastroenterology & hepatology 2013;6(6):683-93; quiz 694

PMID: 23237254

Abstract

Treatment of chronic hepatitis B (CHB) with nucleos(t)ide analogs is often required over a prolonged period to achieve durable virologic suppression. One barrier to the success of long-term therapy is the emergence of drug-resistant mutants. Current guidelines therefore recommend the most potent drugs with optimal resistance profiles, that is, entecavir and tenofovir are used as first-line monotherapies in CHB. Characteristics of the hepatitis B virus, the disease, the patient and the drug can influence the response to antiviral treatment and risk of relapse. This review discusses factors to consider maximizing the chances of successful long-term treatment of CHB, and provides an overview of the long-term efficacy and safety data that have become available over the 4-5 years since entecavir and tenofovir were first approved for the treatment of CHB. Recent findings on whether and under what circumstances long-term therapy of CHB might be stopped are also discussed.

Address: IFI Institute for Interdisciplinary Medicine, Asklepios Klinik St Georg, Hamburg, Germany.

DOI: 10.1586/egh.12.52

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MeSH Terms: Adenine, Age Factors, Antiviral Agents, Comorbidity, DNA, Viral, Drug Resistance, Viral, Guanine, Hepatitis B, Chronic, Humans, Lamivudine, Life Style, Organophosphonates, Severity of Illness Index, Telbivudine, Tenofovir, Thymidine, Time Factors