ABSTRACT
Hepatitis B e antigen (HBeAg)-negative chronic hepatitis B evolves in the natural
history of chronic hepatitis B virus (HBV) infection linked with selection of nonproducing
HBeAg but replication-competent HBV mutants, and may have a potentially severe and
progressive course. Effective suppression of HBV replication is the main therapeutic
target. Sustained off-therapy responses are rare with treatment of finite duration,
except perhaps for interferon-based therapies, which induce such responses in a sizeable,
yet small proportion of patients. Eventually, the majority of patients will be treated
with long-term oral antiviral therapy, which improves patients' outcome but is associated
with progressively increasing rates of viral resistance. The long-term resistance
profile of adefovir is significantly better than that of lamivudine (LMV), whereas
data for entecavir currently are limited to 2 years, with resistance developing in
LMV-resistant but not in treatment-naïve patients. Combination therapy with adefovir
added to LMV in LMV-resistant patients is extremely effective; cases of adefovir-resistance
have not been reported to date.
KEYWORDS
Chronic hepatitis B - interferon-alfa - lamivudine - adefovir - entecavir
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Professor
Stephanos J HadziyannisM.D.
Department of Medicine and Hepatology, Henry Dunant Hospital
107 Messogion Avenue, 11526 Athens, Greece
