Virus-related liver cirrhosis: Molecular basis and therapeutic options

Table 1 Current regimes of antiviral treatment for virus-related cirrhosis

Medicine used	Number of patients	Virological responses	Survival	Ref.
HBV-related cirrhosis
ETV (1.0 mg/d) or ADV (10 mg/d)	100 subjects treated with ETV, 91 subjects treated with ADV	57% and 20% of subjects achieve HBV DNA undetectable after 48 wk (ETV and ADV, respectively)	Overall 1-yr patient survival rates were 84% and 83% (ETV and ADV, respectively)	[83]
TBV (600 mg/d) or LAM (100 mg/d)	114 in the TBV group, another 114 in LAM group	49.1% and 39.5% of subjects achieve HBV DNA undetectable after 104 wk (TBV and LAM, respectively)	Overall 1-yr patient survival rates were 94% and 88% (TBV and LAM, respectively)	[85]
ETV (0.5 mg/d)	144 compensated and 55 decompensated cirrhosis patients treated with ETV	78.5% and 89.1% of subjects achieve HBV DNA undetectable after 12 mo (compensated and decompensated, respectively)	Not analyzed	[86]
TDF (300 mg/d) or TDF (300 mg/d) + FTC (200 mg/d) or ETV (0.5 mg/d)	45 in TDF group, 45 in TDF plus FTC group and 22 in ETV group	70.5%, 87.8% and 72.7% achieve HBV DNA undetectable after 48 wk (TDF, TDF plus FTC, ETV, respectively)	Not analyzed	[84]
ADV (10 mg/d)	226 wait-listed and 241 post-LT patients	59% and 40% achieve HBV DNA undetectable after 48 wk (wait-listed and post transplantation, respectively)	Overall 1-yr patient survival rates were 86% and 91% (wait-listed and post transplantation, respectively)	[87]
HCV-related cirrhosis
Group 1: PegIFN-2a + RBV2 Group 2: PegIFN-2b + RBV3 Group 3: PegIFN-2a + placebo4	453 in group 1, 444 in group 2 and 224 in group 3	69%, 52% and 59% achieve SVR1 after 24 wk (group 1, group 2 and group 3, respectively)	Not analyzed	[81]
Treated: IFN5 Untreated: placebo	72 patients in both treated group and untreated group	Not analyzed	5-yr overall survival is 50% and 39% in treated and untreated group, respectively	[89]
Non-LT and LT cirrhotic patients are all treated for PEG-IFN a2a or a2b plus RBV6	43 HCV non-LT cirrhotic patients and 17 LT HCV related-cirrhotic patients	69.8% and 47.1% achieve EVR and 41.9% and 29.4% achieve SVR (non-LT group and LT group, respectively)	None of the non-LT cirrhotic patients died; LT cirrhotic patients with survival rates of 87% at 1 yr and of 76% at 3 and 5 yr after the treatment	[97]

¹Undetectable HCV RNA in serum after 24 wk of post-treatment follow-up;

²Once-weekly injections of 180 mcg of PegIFN-α2a plus RBV (1000 mg/d);

³Thrice-weekly injections of 3 million units of PegIFN-α2b plus RBV (1000 mg/d);

⁴Once-weekly injections of 180 mcg of PegIFN-α2a plus daily placebo;

⁵Treatment started with 1 mega unit three times weekly for three months then increased every three months to 3, 6, and 9 mega units;

⁶Peg-IFN-α2a or -α2b: at the dose of 180 mcg/wk or 1.5 mcg/kg per week respectively; and RBV 800-1200 mg, based on body weight. HBV: Hepatitis B virus; ETV: Entecavir; TBV: Telbivudine; LAM: Lamivudine; ETV: Entecavir; ADV: Adefovir; TDF: Tenofovir disoproxil fumarate; FTC: Emtricitabine; HCV: Hepatitis C virus; SVR: Sustained virological response; PegIFN: Peginterferon; RBV: Ribavirin; CHB: Chronic hepatitis B; IFN: Interferon; LT: Liver transplanted; EVR: Early virological response.