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Selection of chronic hepatitis B therapy with high barrier to resistance

Identifieur interne : 005929 ( Main/Exploration ); précédent : 005928; suivant : 005930

Selection of chronic hepatitis B therapy with high barrier to resistance

Auteurs : Robert Gish [États-Unis] ; Ji-Dong Jia [République populaire de Chine] ; Stephen Locarnini [Australie] ; Fabien Zoulim [France]

Source :

RBID : Pascal:12-0183144

Descripteurs français

English descriptors

Abstract

Antiviral drug resistance is a crucial factor that frequently determines the success of long-term therapy for chronic hepatitis B. The development of resistance to nucleos(t)ide analogues has been associated with exacerbations in liver disease and increased risk of emergence of multidrug resistance. The selection of a potent nucleos(t)ide analogue with a high barrier to resistance as a first-line therapy, such as entecavir or tenofovir, provides the best chance of achieving long-term treatment goals and should be used wherever possible. The barrier to resistance of a given nucleos(t)ide analogue is influenced by genetic barrier, drug potency, patient adherence, pharmacological barrier, viral fitness, mechanism of action, and cross-resistance. In countries with limited health-care resources, the selection of a therapy with a high barrier to resistance is not always possible and alternative strategies for preventing resistance might be needed, although limited data are available to support these strategies.


Affiliations:


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Le document en format XML

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<s1>Center for Hepatobiliary Disease and Abdominal Transplantation, UC San Diego Health System</s1>
<s2>San Diego, CA</s2>
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<country>États-Unis</country>
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<name sortKey="Jia, Ji Dong" sort="Jia, Ji Dong" uniqKey="Jia J" first="Ji-Dong" last="Jia">Ji-Dong Jia</name>
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<s1>Liver Research Center, Beijing Friendship Hospital, Capital Medical University</s1>
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<country>République populaire de Chine</country>
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<settlement type="city">Pékin</settlement>
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<name sortKey="Locarnini, Stephen" sort="Locarnini, Stephen" uniqKey="Locarnini S" first="Stephen" last="Locarnini">Stephen Locarnini</name>
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<country>France</country>
<placeName>
<region type="region">Auvergne-Rhône-Alpes</region>
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<s1>Hospices Civils de Lyon, Hepatology Department</s1>
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<div type="abstract" xml:lang="en">Antiviral drug resistance is a crucial factor that frequently determines the success of long-term therapy for chronic hepatitis B. The development of resistance to nucleos(t)ide analogues has been associated with exacerbations in liver disease and increased risk of emergence of multidrug resistance. The selection of a potent nucleos(t)ide analogue with a high barrier to resistance as a first-line therapy, such as entecavir or tenofovir, provides the best chance of achieving long-term treatment goals and should be used wherever possible. The barrier to resistance of a given nucleos(t)ide analogue is influenced by genetic barrier, drug potency, patient adherence, pharmacological barrier, viral fitness, mechanism of action, and cross-resistance. In countries with limited health-care resources, the selection of a therapy with a high barrier to resistance is not always possible and alternative strategies for preventing resistance might be needed, although limited data are available to support these strategies.</div>
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