Journal List > J Korean Med Assoc > v.48(5) > 1080520

Song: Antiviral Treatment of Chronic Hepatitis B and C : Current Update

Abstract

The treatment of chronic viral hepatitis is aimed to prevent the progression to cirrhosis and hepatocellular carcinoma, eventually increasing the survival of the patients through biochemical, virological, and histological improvement. Recently, international and domestic consensus on management guidelines for chronic viral hepatitis B and C have been announced and recommended. Interferon-α·, lamivudine, or adefovir dipivoxil, approved by FDA, can be used in the treatment of chronic hepatitis B according to the patient and virus characteristics, while the internationally standardized antiviral regimen for chronic hepatitis C is a combination therapy of pegylated interferon-α· and ribavirin. Among these antiviral agents, adefovir dipivoxil, a nucleoside analogue of adenosine monophosphate, is known to be effective in treatment of chronic hepatitis B with the lamivudine-resistant YMDD mutant. The antiviral treatment of chronic viral hepatitis can be individualized to get the maximal treatment effect in a cost-effective manner through taking consideration of the patient status, side effects of antiviral agents, administration route, insurance criteria, and the patient' motivation toward medical treatment.

References

1. Consensus statements on the prevention and management of hepatitis B and hepatitis C in the Asia-Pacific region. Core Working Party for Asia-Pacific Consensus on Hepatitis B and C. J Gastroenterol Hepatol. 2000. 15:825–841.
2. Liaw YF, Leung N, Guan R, Lau GK, Merican I. Asian-Pacific Consensus Working Parties on Hepatitis B. Asian-Pacific consensus statement on the management of chronic hepatitis B: an update. J Gastroenterol Hepatol. 2003. 18:239–245.
crossref
3. Lok AS, McMahon BJ. Practice Guidelines Committee, AASLD. Chronic hepatitis B: update of recommendations. Hepatology. 2004. 39:857–861.
crossref
4. Conjeevaram HS, Lok AS. Management of chronic hepatitis B. J Hepatol. 2003. 38:Suppl 1. 90–103.
crossref
5. EASL jury. EASL International Consensus Conference on Hepatitis B. Consensus statement. J Hepatol. 2003. 38:533–540.
7. EASL International Consensus Conference on hepatitis C. Paris, Consensus Statement. J Hepatol. 1999. 30:956–961.
8. National Institutes of Health. National Institutes of Health Consensus Development Conference Statement: management of hepatitis C. Hepatology. 2002. 36:Suppl. 3–20.
9. Strader DB, Wright T, Thomas DL, Seeff LB. AASLD. Diagnosis, management, and treatment of hepatitis C. Hepatology. 2004. 39:1147–1171.
crossref
11. Niederau C, Heintges T, Lange S, Goldmann G, Niederau CM, Haussinger D, et al. Long-term follow-up of HBeAg-positive patients treated with interferon alfa for chronic hepatitis B. N Engl J Med. 1996. 334:1422–1427.
crossref
12. Wong DK, Cheung AM, O'Rourke K, Naylor CD, Detsky AS, Heathcote J. Effect of alpha-interferon treatment in patients with hepatitis B e antigen-positive chronic hapatitis B. A meta-analysis. Ann Intern Med. 1993. 119:312–323.
crossref
13. Papatheodoridis GV, Manesis E, Hadziyannis SJ. The long-term outcome of interferon-alpha treated and untreated patients with HBeAg-negative chronic hepatitis B. J Hepatol. 2001. 34:306–313.
crossref
14. Brunetto MR, Oliveri F, Coco B, Leandro G, Colombatto P, Bonino F, et al. Outcome of anti-HBe positive chronic hepatitis B in alpha-interferon treated and untreated patients: a long term cohort study. J Hepatol. 2002. 36:263–270.
crossref
15. Leung NW, Lai CL, Chang TT, Guan R, Lee CM, Chien RN, et al. On behalf of the Asia Hepatitis Lamivudine Study Group. Extended lamivudine treatment in patients with chronic hepatitis B enhances hepatitis B e antigen seroconversion rate: results after 3 years of therapy. Hepatology. 2001. 33:1527–1532.
crossref
16. Ryu SH, Chung YH, Choi MH, Kim JA, Shin JW, Suh DJ, et al. Long-term additional lamivudine therapy enhances durability of lamivudine-induced HBeAg loss: a prospective study. J Hepatol. 2003. 39:614–619.
crossref
17. Dienstag JL, Goldin RD, Heathcote EJ, Han HW, Woessner M, Schiff ER, et al. Histological outcome during long-term lamivudine therapy. Gastroenterology. 2003. 124:105–117.
crossref
18. Lai CL, Dienstag JL, Schiff ER, Leung NW, Atkins M, Condreay L, et al. Prevalence and clinical correlates of YMDD variants during lamivudine therapy for patients with chronic hepatitis B. Clin Infect Dis. 2003. 36:687–696.
crossref
19. Peter MG, Hann Hw H, Martin P, Heathcote EJ, Buggisch P, Brosgart CL, et al. Adefovir dipivoxil alone or in combination with lamivudine in patients with lamivudine-resistant chronic hepatitis B. Gastroenterology. 2004. 126:91–101.
20. Kearney B, Currie G, Knight W, Jain A, Ebrahimi R. Development and evaluation of dosing guidelines for adefovir dipivoxil in patients with chronic hepatitis B and renal impairment. Hepatology. 2002. 36:638A.
21. Marcellin P, Chang TT, Lim SG, Tong MJ, Sievert W, Brosgart CL, et al. Adefovir Dipivoxil 437 Study Group. Adefovir dipivoxil for the treament of hepatitis B e antigen-positive chronic hepatitis B. N Engl J Med. 2003. 348:808–816.
crossref
22. Perrillo R, Hann HW, Mutimer D, Willems B, Leung N, Schiff E, et al. Adefovir dipivoxil added to ongoing lamivudine in chronic hapatitis B with YMDD mutant hepatitis B virus. Gastroenterology. 2004. 126:81–90.
crossref
23. Marcellin P, Chang TT, Lim SG. Adefovir dipivoxil results in a consistent and significant improvement in liver histology and clinical status regardless of baseline Knodell fibrosis score in patients with HBeAg+ chronic hepatitis B. Gastroenterology. 2003. 124:A714.
24. Perrillo R, Schiff E, Han H-W. The addition of adefovir dipivoxil to lamivudine in decompensated chronic hepatitis B patients with YMDD variant HBV and reduced reponse to lamivudine-preliminary 24 week results. Hepatology. 2001. 34:349A.
25. Hadziyannis SJ, Tassopoulos NC, Heathcote EJ, Chang TT, Kitis G, Marcellin P, et al. Two year results from a double-blind, randomized, placebo-controlled study of adefovir dipivoxil for presumed precore mutant chronic hepatitis B (abstract). J Hepatol. 2003. 38:Suppl. 143.
crossref
26. Hadziyannis SJ, Tassopoulos NC, Heathcote EJ, Chang TT, Kitis G, Brosgart CL, et al. Adefovir Dipivoxil 438 Study Group. Adefovir dipivoxil for the treatment of hepatitis B e antigen-negative chronic hepatitis B. N Engl J Med. 2003. 348:800–807.
crossref
27. Angus P, Vaughan R, Xiong S, Yang H, Delaney W, Locarnini S. Resistance to adefovir dipivoxil therapy associated with the selection of a novel mutation in the HBV polymerase. Gastroenterology. 2003. 125:292–297.
crossref
28. Alberti A, Benvegnu L. Management of hepatitis C. J Hepatol. 2003. 38:Suppl. 104–118.
crossref
29. Reddy KR, Wright TL, Pockros PJ, Shiffman M, Everson G, DePamphilis j, et al. Efficacy and safety of pegylated (40-kd) interferon alpha-2a compared with interferon alpha-2a in noncirrhotic patients with chronic hepatitis C. Hepatology. 2001. 33:433–438.
crossref
30. Fried MW, Shiffman ML, Reddy KR, Smith C, Marinos G, Yu J, et al. Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med. 2002. 347:975–982.
crossref
31. Hadziyannis SJ, Sette H Jr, Morgan TR, Balan V, Diago M, Ackrill AM, et al. PEGASYS International Study Group. Peginterferon alpha-2a and rivavirin combination therapy in chronic hepatitis C: a randomized study of treatment duration and ribavirin dose. Ann Intern Med. 2004. 140:346–355.
crossref
32. Manns MP, McHutchison JG, Gordon SC, Rustgi VK, Shiffman M, Albrecht JK, et al. Peginterferon alfa-2b plus ribavirin compared to interferon alfa 2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial. Lancet. 2001. 358:958–965.
crossref
33. Davis GL. Monitoring of viral levels during therapy of hepatitis C. Hepatology. 2002. 36:5 Suppl 1. 145–151.
crossref
34. Davis GL, Wong JB, McHutchison JG, Manns MP, Harvey J, Albrecht J. Early virologic response to treatment with peginterferon alfa-2b plus ribavirin in patients with chronic heaptitis C. Hepatology. 2003. 38:645–652.
crossref
35. Fried MW. Side effects of therapy of hepatitis C and their management. Hepatology. 2002. 36:5 Suppl 1. 237–244.
crossref
36. Russo MW, Fried MW. Side effects of therapy for chronic hepatitis C. Gastroenterology. 2003. 124:1711–1719.
crossref
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