Περίληψη:
Hepatitis B e antigen (HBeAg)-negative chronic hepatitis B evolves in
the natural history of chronic hepatitis B virus (HBV) infection linked
with selection of nonproducing HBeAg but replication-competent HBV
mutants, and may have a potentially severe and progressive course.
Effective suppression of HBV replication is the main therapeutic target.
Sustained off-therapy responses are rare with treatment of finite
duration, except perhaps for interferon-based therapies, which induce
such responses in a sizeable, yet small proportion of patients.
Eventually, the majority of patients will be treated with long-term oral
antiviral therapy, which improves patients’ outcome but is associated
with progressively increasing rates of viral resistance. The long-term
resistance profile of adefovir is significantly better than that of
lamivudine (LMV), whereas data for entecavir currently are limited to 2
years, with resistance developing in LMV-resistant but not in
treatment-naive patients. Combination therapy with adefovir added to LMV
in LMV-resistant patients is extremely effective; cases of
adefovir-resistance have not been reported to date.
