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©2014 Baishideng Publishing Group Inc.
World J Hepatol. May 27, 2014; 6(5): 284-292
Published online May 27, 2014. doi: 10.4254/wjh.v6.i5.284
Published online May 27, 2014. doi: 10.4254/wjh.v6.i5.284
Table 1 European Association for the Study of the Liver guidelines compared to other international guidelines
Table 2 Main advantages and disadvantages of pegylated interferon alpha and nucleos(t)ides analogues in chronic hepatitis B[6]
Peg-IFN | Nucleos(t)ides analogues | |
Advantages | Finite duration (usually 48 wk) | Potent antiviral effect |
Higher rates of anti-HBe and anti-HBs seroconversion with 12 mo of therapy | Excellent tolerance, good safety | |
Absence of resistance | Oral administration (once daily) | |
No contraindication for treatment | ||
Disadvantages | Moderate antiviral effect | Unknown (perhaps indefinite) duration of treatment |
Inferior tolerability | Rare HBsAg loss | |
Risk of adverse events | Risk of viral resistance | |
Subcutaneous injections | Unknown long-term safety | |
Contraindications in specific patient subgroups |
Table 3 Cross-resistance data for the most frequent resistant hepatitis B virus variants[43]
HBV variant | LVD | LdT | ETV | ADV | TDF |
Wild-type | S | S | S | S | S |
M204I/V | R | R | I | S | S |
L180M + M204V | R | R | I | S | S |
A181T/V | R | R | S | R | I |
N236T | S | S | S | R | I |
A181T/V + N236T | R | R | S | R | R |
L180M + M204V/I ± I179T ± T184G ± S202I/G ± M250I/V | R | R | R | S | S |
Table 4 European Association for the Study of the Liver 2012 Guidelines recommendations in resistant patients[6]
Resistance | Action |
LAM resistance | Switch to TDF (add ADV if TDF not available) |
ADV resistance | If patient was NA naive before ADV: switch to ETV or TDF; |
ETV may be preferred in such patients with high viremia | |
If patient had prior LAM resistance: switch to TDF and add a nucleoside analogue | |
LdT resistance | Switch to or add TDF (add ADV if TDF not available) |
ETV resistance | Switch to or add TDF (add ADV if TDF not available) |
TDF resistance | TDF resistance not detected to date: add a nucleoside analogue |
Switch to ETV if patient had no prior LAM resistance or add ETV in patients with LAM resistance |
- Citation: Santantonio TA, Fasano M. Chronic hepatitis B: Advances in treatment. World J Hepatol 2014; 6(5): 284-292
- URL: https://www.wjgnet.com/1948-5182/full/v6/i5/284.htm
- DOI: https://dx.doi.org/10.4254/wjh.v6.i5.284