Advances in Therapy for Chronic Hepatitis B

Abstract

Two agents are currently approved for the treatment of chronic hepatitis B: interferon alfa and lamivudine. Each agent has inherent limitations for use in the treatment of chronic hepatitis B. Interferon alfa is effective in a small number of patients and has serious side effects that limit its tolerability. The efficacy of lamivudine is limited by the emergence of drug-resistant hepatitis B virus (HBV) mutants, restricting its utility as a long-term therapy for chronic hepatitis B. As a result, a large proportion of chronic hepatitis B patients continue to be in need of a safe and efficacious therapy. This article provides an integrated analysis of the safety and efficacy of a new nucleotide analogue, adefovir dipivoxil, based on emerging data from recent studies. The study groups include patients with hepatitis B e antigen (HBeAg)-positive and HBeAg-negative chronic hepatitis B; lamivudine-resistant patients with compensated liver disease; lamivudine-resistant patients coinfected with the human immunodeficiency virus (HIV); and lamivudine-resistant pretransplant and posttransplant patients with decompensated liver disease. Adefovir dipivoxil 10 mg/d demonstrated potent anti-HBV activity consistently across this broad range of patient populations and was well-tolerated. Adefovir dipivoxil's effects include rapid and sustained virological, serological, histological, and biochemical responses, with minimal adverse effects. Significant histological improvement was seen in all patient subgroups at 48 weeks.

Adefovir Dipivoxil, Tenofovir Disoproxil Fumarate or Lamivudine; Which is Suitable Monotherapy Medication in the Patients with Chronic Hepatitis B Virus Infection? One Year Experience

“…Same our study, Pradeep et al [20] in their study expressed that 6 month medication by Adefovir Dipivoxil and Lamivudine can significantly decrease ALT level and viral load in HBV patients. In their study, no significant difference was observed between Adefovir Dipivoxil and Lamivudine groups to ALT level and HBeAg seroconversion after 6 month therapy [18], but we have a significant decrease ALT level in Lamivudine group after 6 month. Furthermore, in this study after 12 month, Lamivudine significantly better than Adefovir Dipivoxil and Tenofovir Disoproxil Fumarate was able to normalized ALT level.…”

“…However, viral gene mutation that laid to Lamivudine resistance is event frequently [18]. Recently, Adefovir Dipivoxil, a prodrug of Adefovir, was approved for used in chronic hepatitis B patients [14,19,20].…”

Oxymatrine therapy for chronic hepatitis B: A randomized double-blind and placebo-controlled multi-center trial

“…Recently, lamivudine was approved for the treatment of chronic HBV infection in many regions of the world. Although convenient and well-tolerated, lamivudine's efficacy rate was similar to interferon and prolonged administration of lamivudine was associated with development of resistance [24][25][26][27][28][29][30] . New agents, such as adefovir dipivoxil, offered a promise either alone or in combination with lamivudine in the treatment of individuals who were 'treatment naïve' have developed lamivudine resistance [31][32][33] .…”

High expression of hepatitis B virus based vector with reporter gene in hepatitis B virus infection system

“…Currently, nucleoside analogues, such as lamivudine and adefovir, are new treatment options that result in a rapid decrease in serum HBV DNA, as well as an improvement of liver histology. Unfortunately, these agents are associated with a rapid rate of relapse and selection of resistant viral variants [5,6] . As such, novel therapeutic alternatives are continually being explored.…”