| Theme |
Hepatitis B : Towards the Elimination |
| Title |
Long‒Term Treatment of Chronic Hepatitis B Using Nucleot(s)ide Analogues and Development of Drug‒resistant Viruses |
| Author |
Masataka Tsuge |
Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University |
| Author |
Kazuaki Chayama |
Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University |
| [ Summary ] |
Since November 2000, 4 nucleo(s)ide analogues (NAs ; lamivudine, adefovir dipivoxil, entecavir, and tenofovir disoproxil fumarate） have been approved for chronic hepatitis B treatment in Japan. NA therapy can strongly suppress hepatitis B virus (HBV) replication by inhibiting DNA synthase and reverse transcription during the HBV life cycle, leading to an improvement in liver injury and suppression of hepatocarcinogenesis. However, NA therapy should be continued for long periods of time given the difficultly of achieving complete HBV eradication. However, it is important to note that prolonged NA therapy may lead to adverse events, such as renal dysfunction or hypophosphatemia, and the development of drug‒resistant HBV clones. According to the recent guidelines for the treatment of chronic hepatitis B propounded by the Japan Society of Hepatology, HBsAg loss is indicated as the final goal. However, although it is difficult to achieve this goal through NA therapy alone, novel drugs are expected to be developed that will reduce HBsAg levels. |