Review article: nucleoside analogues for the treatment of chronic hepatitis B
Article first published online: 6 DEC 2004
Alimentary Pharmacology & Therapeutics
Volume 20, Issue 11-12, pages 1211–1230, December 2004
How to Cite
Younger, H. M., Bathgate, A. J. and Hayes, P. C. (2004), Review article: nucleoside analogues for the treatment of chronic hepatitis B. Alimentary Pharmacology & Therapeutics, 20: 1211–1230. doi: 10.1111/j.1365-2036.2004.02211.x
- Issue published online: 6 DEC 2004
- Article first published online: 6 DEC 2004
- Accepted for publication 8 August 2004
Current accepted treatment for chronic hepatitis B uses either the immunomodulator interferon alpha or nucleoside analogues lamivudine or adefovir. Interferon has side effects which mean it is often poorly tolerated. Long-term use of lamivudine is associated with increasing viral resistance for each year it is taken and the rebound viraemia that can occur when the drug is stopped is also of concern to many. Adefovir appears to have less of the resistance issues of lamivudine but is still a relatively new drug and at present its use is principally limited to patients with lamivudine-resistant disease.
A number of other nucleoside analogues are currently being developed with some now at the stage of early clinical trials. A proportion share the significant resistance problems of lamivudine but many appear to have more potent anti-viral effect than the drugs currently available. If some of these newer anti-viral agents are approved for use in chronic hepatitis B, the potential for prolonged suppression of hepatitis B virus replication with resultant stabilization or improvement in liver disease may be achieved.