Abstract
Infection with the hepatitis B virus has switched over the last 20 years from the classical HBeAg positive serologic pattern to a HBeAg negative form that is linked, in the Mediterranean basin, with the epidemiologic replacement of the causative wild-type of virus B with mutant variants, whereby mutations in the core-promoter and in the pre-core region prevent the secretion of HBeAg. The wild-type pattern of infection (characterized by relatively high steady level ALT, high HBV-DNA levels and clinically overt liver disease) responds relatively well to Interferon: 3 to 5 mega units daily or 10 mega units every other day for 16 weeks induce anti-HBe seroconv ersion, normalize the ALT and possibly also eliminate the HBsAg in some 40% of the adults with a minimal (7%) risk of relapse. However, the mutant type infection (anti-HBe positive / HBe Ag negative) is less responsive to Interferon; this has led to the search for novel nucleoside analogues which has currently culminated in the advent of Lamivudine. This competitor of cytidine is 80% bioavailable and devoid of side-effects at the oral dose of 100 mg daily; tolerance continues for therapies up to 3 years. Lamivudine therapy shares with Interferon a rapid decline of ALT accompanied by improvement of histology; at variance with Interferon there is a delayed accumulating seronconversion to anti-HBe and the switch to anti-HBs is rare. Over the long term its activity is abolished by the emergence of specific viral mutations (YMDD mutants) that rekindle the disease. The indications to Lamivudine therapy in HBeAg negative chronic hepatitis B are currently under investigation. Lamivudine is highly efficacious in preventing HBV reinfection in liver transplants.
Keywords: hepatitis b, hbeag negative form, lamivudine, ymdd mutant
Current Pharmaceutical Design
Title: Treatment of Chronic Hepatitis B
Volume: 8 Issue: 11
Author(s): M. Lagget and M. Rizzetto
Affiliation:
Keywords: hepatitis b, hbeag negative form, lamivudine, ymdd mutant
Abstract: Infection with the hepatitis B virus has switched over the last 20 years from the classical HBeAg positive serologic pattern to a HBeAg negative form that is linked, in the Mediterranean basin, with the epidemiologic replacement of the causative wild-type of virus B with mutant variants, whereby mutations in the core-promoter and in the pre-core region prevent the secretion of HBeAg. The wild-type pattern of infection (characterized by relatively high steady level ALT, high HBV-DNA levels and clinically overt liver disease) responds relatively well to Interferon: 3 to 5 mega units daily or 10 mega units every other day for 16 weeks induce anti-HBe seroconv ersion, normalize the ALT and possibly also eliminate the HBsAg in some 40% of the adults with a minimal (7%) risk of relapse. However, the mutant type infection (anti-HBe positive / HBe Ag negative) is less responsive to Interferon; this has led to the search for novel nucleoside analogues which has currently culminated in the advent of Lamivudine. This competitor of cytidine is 80% bioavailable and devoid of side-effects at the oral dose of 100 mg daily; tolerance continues for therapies up to 3 years. Lamivudine therapy shares with Interferon a rapid decline of ALT accompanied by improvement of histology; at variance with Interferon there is a delayed accumulating seronconversion to anti-HBe and the switch to anti-HBs is rare. Over the long term its activity is abolished by the emergence of specific viral mutations (YMDD mutants) that rekindle the disease. The indications to Lamivudine therapy in HBeAg negative chronic hepatitis B are currently under investigation. Lamivudine is highly efficacious in preventing HBV reinfection in liver transplants.
Export Options
About this article
Cite this article as:
Lagget M. and Rizzetto M., Treatment of Chronic Hepatitis B, Current Pharmaceutical Design 2002; 8 (11) . https://dx.doi.org/10.2174/1381612024607054
DOI https://dx.doi.org/10.2174/1381612024607054 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Cancer Microbiome; Opportunities and Challenges
Endocrine, Metabolic & Immune Disorders - Drug Targets T Cell Immunity to HIV: Defining Parameters of Protection
Current HIV Research Antifungal Activity of Plant Secondary Metabolites on <i>Candida albicans</i>: An Updated Review
Current Molecular Pharmacology Vascular Endothelial Growth Factor in Central Nervous System Injuries – A Vascular Growth Factor Getting Nervous?
Current Neurovascular Research New Insights into Inflammatory Bowel Disease Pathophysiology: Paving the Way for Novel Therapeutic Targets
Current Drug Targets RAAS Inhibition and Cardiorenal Syndrome
Current Hypertension Reviews Maximizing Baculovirus-Mediated Foreign Proteins Expression in Mammalian Cells
Current Gene Therapy Caspase-1-independent Maturation of IL-1β in Ischemic Brain Injury: is there a Role for Gelatinases?
Mini-Reviews in Medicinal Chemistry Current Paradigms in COVID-19 Research: Proposed Treatment Strategies, Recent Trends and Future Directions
Current Medicinal Chemistry The Complexity of Omega-3 Fatty Acid Modulation of Signaling Pathways Related to Pancreatic Cancer
Current Medicinal Chemistry Current Molecular Understanding and Future Treatment Strategies for Pathologic Ocular Neovascularization
Current Molecular Medicine Fibroblast Activation Protein in Remodeling Tissues
Current Molecular Medicine The High Mobility Group A1 (HMGA1) Transcriptome in Cancer and Development
Current Molecular Medicine Metabolism in Patients with Rheumatoid Arthritis: Resting Energy Expenditure, Physical Activity and Diet-Induced Thermogenesis. Invited Review
Recent Patents on Endocrine, Metabolic & Immune Drug Discovery Mass Spectrometry Characterization of Plant Phosphoproteins
Current Protein & Peptide Science Using Cytokines to Treat Cervical Intraepithelial and Invasive Neoplasia
Recent Patents on Anti-Cancer Drug Discovery Role of Intra-Luminal Pressure in Regulating PBF in the Fetus and After Birth
Current Pediatric Reviews Genetically-modified Stem Cell in Regenerative Medicine and Cancer Therapy; A New Era
Current Gene Therapy Differential Gene Expression of <i>ASUN, NEMF, PTPRC</i> and <i>DHX29</i>: Candidate Biomarkers for the Diagnosis of Active and Latent Tuberculosis
Infectious Disorders - Drug Targets Using Serum Biomarkers for Identifying Unstable Carotid Plaque: Update of Current Evidence
Current Pharmaceutical Design