Back to Journals » Drug Design, Development and Therapy » Volume 7
Update on rescue therapies in patients with lamivudine-resistant chronic hepatitis B
Received 26 February 2013
Accepted for publication 5 June 2013
Published 20 August 2013 Volume 2013:7 Pages 777—788
DOI https://doi.org/10.2147/DDDT.S33947
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Daniel C Chao, Ke-Qin Hu
Division of Gastroenterology and Hepatology, University of California, Irvine Medical Center, Orange, CA, USA
Abstract: Chronic hepatitis B continues to be a global problem, with an estimated 240 million cases according to the World Health Organization. Chronic infection with the hepatitis B virus (HBV) is associated with cirrhosis, hepatic decompensation, and hepatocellular carcinoma. There are currently several US Food and Drug Administration-approved medications for treating chronic hepatitis B, with Lamivudine (LAM) being the first oral agent made available. The major problem with LAM is significantly decreased effectiveness over time due to the development of anti-HBV resistance that can lead to virologic and biochemical breakthrough as well as hepatitis B flare, progression of liver disease, and decompensation of pre-existing cirrhosis. Despite its high anti-HBV resistant rate, LAM remains widely used in underdeveloped countries due to its wide availability and low cost compared to other antiviral medications, including those that are more effective. Therefore, it is still clinically important to learn how to prevent and treat LAM resistant strains of HBV. Several regimens with the other available antiviral agents have been studied, including switching to monotherapy with either Adefovir, Entecavir, or Tenofovir, adding Adefovir to LAM, and switching to a combination of Adefovir and Entecavir. This review article will examine molecular mechanisms and diagnosis of LAM anti-HBV resistance, risks for and approaches to reduce LAM anti-HBV resistance, and currently available rescue therapy regimens for LAM resistance.
Keywords: chronic hepatitis B, nucleot(s)ide analogs, anti-viral resistance, lamivudine, adefovir, entecavir, tenofovir
© 2013 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.