Antiviral treatment for chronic hepatitis B: Safety, effectiveness, and prognosis

作     者：Ya-Li Wu Cheng-Li Shen Xin-Yue Chen 

作者机构：International Medical DepartmentBeijing Youan HospitalCapital Medical UniversityBeijing 100069China Division of Surgical OncologyJames Cancer HospitalThe Ohio State University Wexner Medical CenterColumbusOH 43210United States 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2019年第7卷第14期

页      面：1784-1794页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：Supported by the Thirteenth Five-Year Major Science and Technology Projects,No.2017ZX10202201 and No.2017ZX10201021-001-008 the Capital Characteristic Clinical Application Research and Extension of Achievements,No.Z151100004015181 and No.Z161100000516018 the Capital Health Research and Development Projects,No.2016-1-2183 Special Fund for Clinical Medical Research of the Chinese Medical Association,No.15030270615 

主　　题：Chronic hepatitis B Antiviral treatment endpoint Safety Prognosis improvement Hepatitis B surface antigen clearance 

摘      要：The goal of chronic hepatitis B (CHB) therapy is to improve the patient prognosis through the sustained inhibition of viral replication. However, due to the uncertainty and potentially unlimited duration of the treatment course, nucleus(t)ide analogue (NA) resistance and safety, financial costs and patient compliance, different endpoints of antiviral treatment have been proposed in CHB prevention and treatment guidelines. Different treatment endpoints are closely associated with the safety of drug withdrawal and improvements in prognosis. Antiviral treatment suppresses HBV DNA replication, drug withdrawal leads to relapse, and long-term treatment causes drug safety and resistance issues. Although hepatitis B e antigen seroconversion based on HBV DNA inhibition is considered as “a satisfactory endpoint, drug withdrawal still leads to high relapse rates. Hepatitis B surface antigen (HBsAg) clearance is the “ideal endpoint in terms of the safety of drug withdrawal and improvements in prognosis. However, the HBsAg clearance rate is low using the conventional single drug treatment and fixed course regimens. Recently, the application of an “optimized antiviral treatment strategy has improved the HBsAg clearance rate, and make an “ideal endpoint possible. This article reviews the different antiviral treatment endpoints in terms of the safety of drug withdrawal, improvements in prognosis and relevant advances.