Current status of drug therapy for chronic hepatitis B

Table 1 Characteristics of anti hepatitis B virus drugs

Drug	Approve time (year)	Classification	Mechanism	Administration method	Metabolize	Major side effect	Drug resistance
LAM	1998	NRTI	Competitive binding to HBV DNA polymerase binding site[64]	Oral administration	Kidney	Less side effects, may lead to myopathy or even rhabdomyolysis[65]	Susceptible to drug resistance, especially YMDD mutation[68]
LDT	2008	NRTI	Competitive binding to HBV DNA polymerase binding site[78]	Oral administration	Kidney	Myopathy and peripheral neuropathy[74]	The rate of drug resistance in long-term treatment was high, and the common drug resistance mutations were rtM204I and rtL180M [79,85]
ADV	2002	NtRTI	Competitive binding of HBV DNA polymerase binding site and embedding into viral DNA strand[71]	Oral administration	Kidney	Renal function damage[75]	Compared to LAM, the risk of resistance is low[71]
ETV	2005	NRTI	Competitive binding to HBV DNA polymerase binding site[12,13]	Oral administration	Kidney	Less side effects, possible renal function damage[14]	Low resistance rate, but resistance to LAM-resistant HBV increased[16,20]
TDF	2008	NtRTI	Competitive binding of HBV DNA polymerase binding site and embedding into viral DNA strand[26]	Oral administration	Kidney	Bone and kidney injury[34]	Low risk of drug resistance
TAF	2016	NtRTI	Competitive binding to HBV DNA polymerase binding site[43]	Oral administration	Liver	Fewer bone and kidney side effects, but can lead to dyslipidemia[52]	Low risk of drug resistance
TMF	2021	NtRTI	Competitive binding to HBV DNA polymerase binding site[56]	Oral administration	Liver	Fewer bone and kidney side effects[58]	Low risk of drug resistance, and effective against multiple drug-resistant HBV
INF-α	1986	Standard interferon	Regulate the immune response and induce the synthesis of antiviral proteins in host cells[87]	Subcutaneous injection	Kidney	More side effects: Systemic adverse reactions	No drug resistance
Peg-IFN-α	2001	Long-acting Interferon	Regulate the immune response and induce the synthesis of antiviral proteins in host cells[87]	subcutaneous injection	Liver and kidney	Similar to INF-α	No drug resistance

NRTI: Nucleoside reverse transcriptase inhibitors, NtRTI: Nucleotide reverse transcriptase inhibitors; LAM: Lamivudine; ADV: Adefovir dipivoxil; ETV: Entecavir; LdT: Telbivudine; TDF: Tenofovir disoproxil fumarate; TAF: Tenofovir disoproxil fumarate; TMF: Tenofovir amibufenamide; IFN: Interferon; Peg-IFN-α: Polyethylene glycol interferon α; YMDD: Polymerase-tyrosine-methionine-aspartate; HBV: Hepatitis B virus.