慢性乙型肝炎的治疗。

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Marcellin P, Asselah T, Boyer N

慢性乙型肝炎的治疗。

J病毒Hepat。2005年7月,12 (4):333 - 45。

PubMed ID

15985003 (在PubMed

]

文摘

在过去的几年内,已经取得了显著的进展在治疗慢性乙型肝炎的疗效拉米夫定,第一个核苷类似物,受到阻力的高发病率。阿德福韦,最近批准了一个类似的功效很低频率的阻力。然而,阿德福韦需要无限期地管理戒断的治疗通常是与复活和持续的反应是罕见的。最近的大型随机对照试验表明,盯住干扰素诱导相对较高的持续应答率e抗原阳性和e抗原阴性慢性肝炎b。到目前为止,与拉米夫定钉IFN的结合,同时使用,是令人失望的短期疗效。然而,长期疗效需要评估和不同时间的组合(例如顺序)需要被评估。核苷类似物,有利的毒性资料,承诺增加对乙肝病毒的有效性,处于不同的临床开发阶段。恩替卡韦的III期试验的结果和emtricitabine证实了他们的功效。然而,尽管恩替卡韦与低发生率的阻力有关,emtricitabine与阻力的发生率相对较高,限制了其作为单一疗法。新的、更有效的药物的疗效和安全性telbivudine和clevudine需要确认。慢性乙型肝炎治疗的未来似乎在不同药物的组合。 Ideally, the optimal drugs to combine would meet the following criteria: they should have different sites of action on HBV DNA replication, a potent antiviral effect, an excellent safety profile and they should induce a sustained response with a limited duration of therapy. Indeed, the concept of combination therapy has been recently developed in order to increase efficacy and to decrease the occurrence of viral resistance. However, so far few combinations have been evaluated. No combination therapy demonstrated a benefit as compared with monotherapy. More potent drugs and new combinations together with the understanding of the mechanisms of resistance to therapy are important challenges to improve the efficacy of treatment and decrease in the future the global burden related to chronic hepatitis B.

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药物

Telbivudine