Financial support: This study was supported by grants from the National Grand Program on Key Infectious Disease (No. 2008ZX10002-004, No. 2012ZX10002-003, No. 2009ZX10004-314).
ADVANCES IN CLINICAL PRACTICE
Prevention and management of drug resistant hepatitis B virus infections
Article first published online: 21 AUG 2012
© 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd
Journal of Gastroenterology and Hepatology
Volume 27, Issue 9, pages 1432–1440, September 2012
How to Cite
Wang, C., Fan, R., Sun, J. and Hou, J. (2012), Prevention and management of drug resistant hepatitis B virus infections. Journal of Gastroenterology and Hepatology, 27: 1432–1440. doi: 10.1111/j.1440-1746.2012.07198.x
- Issue published online: 21 AUG 2012
- Article first published online: 21 AUG 2012
- Accepted manuscript online: 13 JUN 2012 07:50AM EST
- Accepted for publication 28 May 2012.
- drug-resistant hepatitis B virus;
- hepatitis B virus;
- nucles(t)ide analogues
In the past decade, broadened therapeutic options of oral direct antiviral agents for the treatment of chronic hepatitis B infection include: Lamivudine, Adefovir Dipivoxil, Telbivudine, Entecavir and Tenofovir Disoproxil Fumarate. These direct oral antiviral agents effectively suppress the replication of the virus and reduce the risk of potential liver-related complications. However, prolonged use of these nucleos(t)ide analogues has been associated with drug resistance that compromises the initial clinical benefits. Moreover, the oncogenic risk of mutations due to prolonged nucleos(t)ide analogue therapy needs to be further investigated by in vitro and in vivo studies. In the current era of potent nucleotide analogues, new data are emerging, we are still facing the pool of patients who have developed resistance to the prior generation of nucleos(t)ide analogues. This paper aims to focus on incidence of antiviral drug resistance and virological breakthrough, prudent selection of initial therapy, on-treatment monitoring for drug resistance and revise treatment strategies for patients with resistant virus.