Current and future directions for treating hepatitis B virus infection  

作　　者：Akinobu Tawada Tatsuo Kanda Osamu Yokosuka 

机构地区：[1]Department of Gastroenterology and Nephrology, Chiba Univer-sity, Graduate School of Medicine

出　　处：《World Journal of Hepatology》2015年第11期1541-1552,共12页世界肝病学杂志（英文版）（电子版）

摘　　要：Hepatitis B virus(HBV) persistently infects approximately 350 million people, and approximately 600000 liverrelated deaths are observed per year worldwide. HBV infection is also one of the major risk factors for hepatocellular carcinoma(HCC). The persistence of serum hepatitis B e antigen(HBe Ag) and high level of serum HBV DNA are thought to reflect a high HBV replication status in hepatocytes, causing cirrhosis, HCC and liver-related deaths. It has been reported that antiviral therapy, such as peginterferon and nucleos(t)ide analogues(NUCs), could suppress liver-related death by inhibiting the HBV DNA levels and inducing seroconversion from HBe Ag to antibody to HBe antigen. Currently, peginterferon is widely used, but there are also several disadvantages in the use of peginterferon, such as various adverse events, the administration route and duration. It is difficult to predict the effects of treatment and interferon is contraindicated for the patients with advanced fibrosis of the liver and cirrhosis. With respect to NUCs, entecavir and tenofovir disoproxil fumarate are current the first-choice drugs. NUCs can be administered orally, and their anti-viral effects are stronger than that of peginterferon. However, because cessation of NUC administration leads to high levels of viral replication and causes severe hepatitis, they must be administered for a long time. On the other hand, the use of both interferon and NUCs cannot eliminate covalently closed circular DNA of HBV. In this review, we evaluate the natural course of chronic HBV infection and then provide an outline of these representative drugs, such as peginterferon, entecavir and tenofovir disoproxil fumarate.Hepatitis B virus （HBV） persistently infects approximately350 million people, and approximately 600000 liverrelateddeaths are observed per year worldwide.HBV infection is also one of the major risk factors forhepatocellular carcinoma （HCC）. The persistence ofserum hepatitis B e antigen （HBeAg） and high levelof serum HBV DNA are thought to reflect a high HBVreplication status in hepatocytes, causing cirrhosis,HCC and liver-related deaths. It has been reported thatantiviral therapy, such as peginterferon and nucleos（t）ideanalogues （NUCs）, could suppress liver-relateddeath by inhibiting the HBV DNA levels and inducingseroconversion from HBeAg to antibody to HBe antigen.Currently, peginterferon is widely used, but there arealso several disadvantages in the use of peginterferon,such as various adverse events, the administrationroute and duration. It is difficult to predict the effectsof treatment and interferon is contraindicated for thepatients with advanced fibrosis of the liver and cirrhosis.With respect to NUCs, entecavir and tenofovir disoproxilfumarate are current the first-choice drugs. NUCs canbe administered orally, and their anti-viral effects arestronger than that of peginterferon. However, becausecessation of NUC administration leads to high levels ofviral replication and causes severe hepatitis, they mustbe administered for a long time. On the other hand,the use of both interferon and NUCs cannot eliminatecovalently closed circular DNA of HBV. In this review, weevaluate the natural course of chronic HBV infection andthen provide an outline of these representative drugs,such as peginterferon, entecavir and tenofovir disoproxilfumarate.

关 键 词：HEPATOCELLULAR carcinoma PEGINTERFERON NUCLEOTIDE ANALOGUE Chronic HEPATITIS B 

分 类 号：R512.62[医药卫生—内科学]