[Entecavir - options and obstacles of an effective treatment for chronic hepatitis B].

Abstract

The level of HBV-DNA is a crucial determinant of the progression to liver cirrhosis or hepatocellular carcinoma. Thus the effective suppression of HBV-DNA below the limit of detection of high sensitive assays is a major aim of treatment. This aim will be achieved in almost all patients with current available direct antiviral drugs. However, the development of drug resistance remains a main challenge for the future. Entecavir has a good profile regarding both antiviral efficacy and resistance profile in the treatment of previously untreated patients. After five year on Entecavir more than 90 % of HBe-Ag positive patients had achieved HBV-DNA below 300 copies/ml and resistance developed in only about 1 %. However, patients in whom there had been previous resistance to lamivudine have lower treatment responses and higher resistance rates because only one or two additional mutations in the HBV-polymerase gene are required for the development of entecavir resistance in contrast to three mutations required in treatment naïve patients. In summary, Entecavir adds a new milestone in the treatment of chronic hepatitis B.

• Authors: M Cornberg, M P Manns
• Journal: Deutsche medizinische Wochenschrift (1946) (Dtsch Med Wochenschr) Vol. 135 Issue 1-2 Pg. 32-7 (Jan 2010) ISSN: 1439-4413 [Electronic] Germany
• Vernacular Title: Entecavir - Möglichkeiten und Grenzen einer effektiven Therapie der chronischen Hepatitis B.
• PMID: 20024882 (Publication Type: English Abstract, Journal Article, Review)
• Copyright: Georg Thieme Verlag KG Stuttgart, New York.

Chemical References

• Antigens, Viral
• Antiviral Agents
• entecavir
• Guanine

Topics

• Antigens, Viral (blood)
• Antiviral Agents (pharmacology, therapeutic use)
• Chronic Disease
• Clinical Trials as Topic
• Drug Resistance
• Guanine (analogs & derivatives, pharmacology, therapeutic use)
• Hepatitis B (complications, drug therapy, mortality, pathology)
• Hepatitis B virus (drug effects)
• Humans
• Liver Cirrhosis (etiology)