Long-term efficacy and safety of nucleos(t)ides analogues in patients with chronic hepatitis B
| Autor: | Maria Buti, Rafael Esteban, Luisa Roade, Mar Riveiro-Barciela |
|---|---|
| Přispěvatelé: | Institut Català de la Salut, Unitat del Fetge, Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto Carlos III, Madrid, Spain, Vall d'Hebron Barcelona Hospital Campus |
| Rok vydání: | 2021 |
| Předmět: |
Oncology
medicine.medical_specialty VHB Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores] viral hepatitis TDF Digestive System Diseases::Liver Diseases::Hepatitis::Hepatitis Chronic::Digestive System Diseases::Liver Diseases::Hepatitis::Hepatitis B Chronic [DISEASES] Review Infectious and parasitic diseases RC109-216 Other subheadings::Other subheadings::/drug therapy [Other subheadings] medicine.disease_cause Tenofovir alafenamide 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Pharmacology (medical) Adverse effect Hepatitis B virus Kidney business.industry diagnóstico::pronóstico::resultado del tratamiento [TÉCNICAS Y EQUIPOS ANALÍTICOS DIAGNÓSTICOS Y TERAPÉUTICOS] Hepatitis crònica activa Entecavir Diagnosis::Prognosis::Treatment Outcome [ANALYTICAL DIAGNOSTIC AND THERAPEUTIC TECHNIQUES AND EQUIPMENT] medicine.disease enfermedades del sistema digestivo::enfermedades hepáticas::hepatitis::hepatitis crónica::enfermedades del sistema digestivo::enfermedades hepáticas::hepatitis::hepatitis B crónica [ENFERMEDADES] Infectious Diseases medicine.anatomical_structure TAF 030220 oncology & carcinogenesis Hepatocellular carcinoma Toxicity Avaluació de resultats (Assistència sanitària) 030211 gastroenterology & hepatology ETV Viral hepatitis business Hepatitis B - Tractament medicine.drug |
| Zdroj: | Therapeutic Advances in Infectious Disease, Vol 8 (2021) Therapeutic Advances in Infectious Disease Scientia |
| ISSN: | 2049-937X 2049-9361 |
| DOI: | 10.1177/2049936120985954 |
| Popis: | ETV; VHB; Hepatitis viral ETV; VHB; Viral hepatitis ETV; VHB; Hepatitis viral Nucleos(t)ide analogues with high barrier to resistance are regarded as the principal therapeutic option for chronic hepatitis B (CHB). Treatment with entecavir (ETV), tenofovir disoproxil (TDF) and the later released tenofovir alafenamide (TAF) is highly effective at controlling hepatitis B virus (HBV) infection and, in the vast majority of patients, is well tolerated. No significant differences in viral suppression have been described among the different regimens, although an earlier achievement in biochemical response has been suggested first under TDF and recently under TAF. High barrier to resistance NAs rarely achieve hepatitis B surface antigen sero-clearance, and therefore should be maintained life-long in most cases. This has increased concerns about treatment-related toxicity, especially in patients under TDF with additional risk factors for kidney and bone impairment. TAF has shown a better bone and kidney safety profile than TDF, although it is not yet available worldwide due to its higher cost. Emergence of adverse events should be monitored since treatment-switch to ETV/TAF seems to be effective and safe in HBV mono-infected subjects. Finally, although an effective antiviral treatment leads to a clear improvement in clinical outcome of CHB patients; the risk of developing hepatocellular carcinoma (HCC) is not completely avoided with viral suppression. Whether tenofovir-based regimens provide any additional benefit over ETV in HCC prevention remains unclear and requires further investigation. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. |
| Databáze: | OpenAIRE |
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