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Review article: Biomedical intelligence

Vol. 141 No. 3738 (2011)

Management of chronic hepatitis B: an update

  • Francesco Negro
DOI
https://doi.org/10.4414/smw.2011.13264
Cite this as:
Swiss Med Wkly. 2011;141:w13264
Published
12.09.2011

Summary

Since the publication in 2009 of clinical practice guidelines for the management of hepatitis B virus (HBV) infection by the European Association for the Study of the Liver (EASL), a wealth of new data has emerged regarding the antivirals most commonly used to treat chronic hepatitis B. This review will summarise the most recent knowledge on these drugs, and how this may affect current and future management of HBV infection. Despite the progress in drug development, HBV infection remains a complex entity, characterised by a peculiar interplay between host and viral factors. With the potent drugs currently available, however, its management and control are possible in the majority of cases.

References

  1. Lavanchy D. Worldwide epidemiology of HBV infection, disease burden, and vaccine prevention. J Clin Virol. 2005;34(Suppl 1):S1–3.
  2. Weber A, Boege Y, Reisinger F, Heikenwälder M. Chronic liver inflammation and hepatocellular carcinoma: persistence matters. Swiss Med Wkly. 2011;141:w13197.
  3. http://www.ecdc.europa.eu/en/publications/Publications/TER_100914_Hep_B_C%20_EU_neighbourhood.pdf (accessed July 31, 2010)
  4. Nardone A, Anastassopoulou CG, Theeten H, Kriz B, Davidkin I, Thierfelder W, O’Flanagan D, et al. A comparison of hepatitis B seroepidemiology in ten European countries. Epidemiol Infect. 2009;137:961–9.
  5. Rantala M, van de Laar MJ. Surveillance and epidemiology of hepatitis B and C in Europe – a review. Euro Surveill. 2008;13.
  6. Kammerlander R, Zimmermann H. Epidemiology of hepatitis B in Switzerland. Soz Praventivmed. 1998;43(Suppl 1):S27–30, S101–4.
  7. Bart PA, Jacquier P, Zuber PL, Lavanchy D, Frei PC. Seroprevalence of HBV (anti-HBc, HBsAg and anti-HBs) and HDV infections among 9006 women at delivery. Liver. 1996;16:110–6.
  8. Russmann S, Dowlatshahi EA, Printzen G, Habicht S, Reichen J, Zimmermann H. Prevalence and associated factors of viral hepatitis and transferrin elevations in 5036 patients admitted to the emergency room of a Swiss university hospital: cross-sectional study. BMC Gastroenterol. 2007;7:5.
  9. Frischknecht F, Sell W, Trummer I, Brühwiler H. Serological testing for infectious diseases in pregnant women: are the guidelines followed? Swiss Med Wkly. 2011;140:w13138.
  10. Brunetto MR, Oliveri F, Colombatto P, Moriconi F, Ciccorossi P, Coco B, et al. Hepatitis B surface antigen serum levels help to distinguish active from inactive hepatitis B virus genotype D carriers. Gastroenterology. 2010;139:483–90.
  11. Liaw YF, Brunetto MR, Hadziyannis S. The natural history of chronic HBV infection and geographical differences. Antivir Ther. 2010;15(Suppl 3):25–33.
  12. European Association For The Study Of The Liver. EASL Clinical Practice Guidelines: management of chronic hepatitis B. J Hepatol. 2009;50:227–42.
  13. Lok AS, McMahon BJ. Chronic hepatitis B: update 2009. Hepatology. 2009;50:661–2.
  14. Fattovich G, Bortolotti F, Donato F. Natural history of chronic hepatitis B: special emphasis on disease progression and prognostic factors. J Hepatol. 2008;48:335–52.
  15. Liaw YF. HBeAg seroconversion as an important end point in the treatment of chronic hepatitis B. Hepatol Int. 2009;3:425–33.
  16. van Zonneveld M, Honkoop P, Hansen BE, Niesters HG, Darwish Murad S, de Man RA, et al. Long-term follow-up of alpha-interferon treatment of patients with chronic hepatitis B. Hepatology. 2004;39:804–10.
  17. Buster EH, Flink HJ, Cakaloglu Y, Simon K, Trojan J, Tabak F, So TMK, et al. Sustained HBeAg and HBsAg loss after long-term follow-up of HBeAg-positive patients treated with peginterferon alpha-2b. Gastroenterology. 2008;135:459–67.
  18. Buster EH, Hansen BE, Lau GK, Piratvisuth T, Zeuzem S, Steyerberg EW, Janssen HL. Factors that predict response of patients with hepatitis B e antigen-positive chronic hepatitis B to peginterferon-alfa. Gastroenterology. 2009;137:2002–9.
  19. Fried MW, Piratvisuth T, Lau GK, Marcellin P, Chow WC, Cooksley G, Luo KX, et al. HBeAg and hepatitis B virus DNA as outcome predictors during therapy with peginterferon alfa-2a for HBeAg-positive chronic hepatitis B. Hepatology. 2008;47:428–34.
  20. Wursthorn K, Lutgehetmann M, Dandri M, Volz T, Buggisch P, Zollner B, Longerich T, et al. Peginterferon alpha-2b plus adefovir induce strong cccDNA decline and HBsAg reduction in patients with chronic hepatitis B. Hepatology. 2006;44:675–84.
  21. Sung JJ, Wong ML, Bowden S, Liew CT, Hui AY, Wong VW, Leung NW, et al. Intrahepatic hepatitis B virus covalently closed circular DNA can be a predictor of sustained response to therapy. Gastroenterology. 2005;128:1890–7.
  22. Levrero M, Pollicino T, Petersen J, Belloni L, Raimondo G, Dandri M. Control of cccDNA function in hepatitis B virus infection. J Hepatol. 2009;51:581–92.
  23. Volz T, Lutgehetmann M, Wachtler P, Jacob A, Quaas A, Murray JM, Dandri M, et al. Impaired intrahepatic hepatitis B virus productivity contributes to low viremia in most HBeAg-negative patients. Gastroenterology. 2007;133:843–52.
  24. Sonneveld MJ, Rijckborst V, Boucher CA, Zwang L, Beersma MF, Hansen BE, Janssen HL. A comparison of two assays for quantification of hepatitis B surface antigen in patients with chronic hepatitis B. J Clin Virol. 2011 May 16.
  25. Lau GK, Marcellin P, Brunetto MR, Piratvisuth T, Kapprell HP, Button P, Batrla R, et al. On-treatment HBsAg decline during peginterferon alfa-2a (40kD) + lamivudine in patients with HBeAg-positive CHB as a potential predictor of durable off-treatment response. Hepatology. 2008;48(Suppl):714A.
  26. Moucari R, Korevaar A, Lada O, Martinot-Peignoux M, Boyer N, Mackiewicz V, et al. High rates of HBsAg seroconversion in HBeAg-positive chronic hepatitis B patients responding to interferon: a long-term follow-up study. J Hepatol. 2009;50:1084–92.
  27. Brunetto MR, Moriconi F, Bonino F, Lau GK, Farci P, Yurdaydin C, et al. Hepatitis B virus surface antigen levels: a guide to sustained response to peginterferon alfa-2a in HBeAg-negative chronic hepatitis B. Hepatology. 2009;49:1141–50.
  28. Rijckborst V, Hansen BE, Cakaloglu Y, Ferenci P, Tabak F, Akdogan M, et al. Early on-treatment prediction of response to peginterferon alfa-2a for HBeAg-negative chronic hepatitis B using HBsAg and HBV DNA levels. Hepatology. 2010;52:454–61.
  29. Sonneveld MJ, Rijckborst V, Boucher CA, Hansen BE, Janssen HL. Prediction of sustained response to peginterferon alfa-2b for hepatitis B e antigen-positive chronic hepatitis B using on-treatment hepatitis B surface antigen decline. Hepatology. 2010;52:1251–7.
  30. Moucari R, Marcellin P. Quantification of hepatitis B surface antigen: a new concept for the management of chronic hepatitis B. Liver Int. 2011;31(Suppl 1):122–8.
  31. Piratvisuth T, Marcellin P. Further analysis is required to identify an early stopping rule for peginterferon therapy that is valid for all hepatitis B e antigen-positive patients. Hepatology. 2011;53:1054–5.
  32. Belloni L, Allweiss L, Guerrieri F, Pediconi N, Volz T, Pollicino T, et al. IFN-α inhibits HBV transcription and replication by targeting the epigenetic regulation of the nuclear cccDNA minichromosome. J Clin Invest. (in press).
  33. Reijnders JG, Perquin MJ, Zhang N, Hansen BE, Janssen HL. Nucleos(t)ide analogues only induce temporary hepatitis B e antigen seroconversion in most patients with chronic hepatitis B. Gastroenterology. 2010;139:491–8.
  34. Lee CM, Ong GY, Lu SN, Wang JH, Liao CA, Tung HD, Chen TM, et al. Durability of lamivudine-induced HBeAg seroconversion for chronic hepatitis B patients with acute exacerbation. J Hepatol. 2002;37:669–74.
  35. Dienstag JL, Cianciara J, Karayalcin S, Kowdley KV, Willems B, Plisek S, Woessner M, et al. Durability of serologic response after lamivudine treatment of chronic hepatitis B. Hepatology. 2003;37:748–55.
  36. Lim S, Aung M, Sutedja D, Lee Y, Lee G, Fernandes ML, Lai V, Dan Y. Treatment induced HBeAg seroconversion is less durable than spontaneous seroconversion. Hepatology. 2010;52(Suppl):442A.
  37. Heathcote EJ, Marcellin P, Buti M, Gane E, De Man RA, Krastev Z, et al. Three-year efficacy and safety of tenofovir disoproxil fumarate treatment for chronic hepatitis B. Gastroenterology. 2011;140:132–43.
  38. Heathcote JE, Gane EJ, deMan RA, Chan S, George J, Tsai NC, et al. Long-term (4 year) efficacy and safety of tenofovir disoproxil fumarate (TDF) treatment in HBeAg-positive patients (HBeAg+) with chronic hepatitis B (study 103): preliminary analysis. Hepatology. 2010;52(Suppl):556A.
  39. Marcellin P, Heathcote EJ, Buti M, Krastev Z, Jacobson I, de Man RA, et al. HBsAg kinetics in patients with chronic hepatitis B (CHB) treated with tenofovir disoproxil fumarate (TDF) for up to 4 years. J Hepatol. 2011;54(Suppl 1):S297.
  40. Gish RG, Lok AS, Chang TT, de Man RA, Gadano A, Sollano J, Han KH, et al. Entecavir therapy for up to 96 weeks in patients with HBeAg-positive chronic hepatitis B. Gastroenterology. 2007;133:1437–44.
  41. Chevaliez S, Hezode C, Grare M, Pawlotsky JM. Long-term monitoring of HBsAg kinetics and prediction of HBsAg clearance in patients with chronic hepatitis B treated with nucleoside/nucleotide analogues. Hepatology. 2010;52(Suppl):506A.
  42. Zoutendijk R, Hansen BE, van Vuuren AJ, Boucher CA, Janssen HL. Prediction of HBsAg loss using HBsAg decline after long-term virological response to nucleos(t)ide analogue therapy for chronic hepatitis B. Hepatology. 2010;52(Suppl):509A.
  43. Liaw YF, Gane E, Leung N, Zeuzem S, Wang Y, Lai CL, Heathcote EJ, et al. 2-Year GLOBE trial results: telbivudine is superior to lamivudine in patients with chronic hepatitis B. Gastroenterology. 2009;136:486–95.
  44. Chang TT, Lai CL, Kew Yoon S, Lee SS, Coelho HS, Carrilho FJ, et al. Entecavir treatment for up to 5 years in patients with hepatitis B e antigen-positive chronic hepatitis B. Hepatology. 2010;51:422–30.
  45. Snow-Lampart A, Chappell B, Curtis M, Zhu Y, Myrick F, Schawalder J, et al. No resistance to tenofovir disoproxil fumarate detected after up to 144 weeks of therapy in patients monoinfected with chronic hepatitis B virus. Hepatology. 2011;53:763–73.
  46. Lampertico P, Viganò M, Soffredini R, Facchetti F, Minola E, Suter F, et al. Maintained long-term suppression of HBV replication in NUC-naïve patients with chronic hepatitis B treated with ETV monotherapy in field practice: the Italian multicenter experience. Hepatology. 2010;52(Suppl):514A.
  47. Yokosuka O, Takaguchi K, Fujioka S, Shindo M, Chayama K, Kobashi H, et al. Long-term use of entecavir in nucleoside-naïve Japanese patients with chronic hepatitis B infection. J Hepatol. 2010;52:791–9.
  48. Fung J, Lai CL, Yuen J, Cheng C, Wu R, Wong DK, Seto WK, et al. Randomized trial of lamivudine versus entecavir in entecavir-treated patients with undetectable hepatitis B virus DNA: outcome at 2 Years. Hepatology. 2011;53:1148–53.
  49. Bihl F, Alaei M, Negro F. The new EASL guidelines for the management of chronic hepatitis B infection adapted for Swiss physicians. Swiss Med Wkly. 2010;140:154–9.
  50. Reijnders JG, Deterding K, Petersen J, Zoulim F, Santantonio T, Buti M, et al. Antiviral effect of entecavir in chronic hepatitis B: influence of prior exposure to nucleos(t)ide analogues. J Hepatol. 2010;52:493–500.
  51. Ha NB, Trinh HN, Ha NB, Nguyen HA, Nguyen K, Nguyen MH. Response to higher dose of entecavir (ETV) 1.0 mg daily in patients with chronic hepatitis B (CHB) and partial response to ETV 0.5 mg daily. Hepatology. 2010;52(Suppl):535A.
  52. van Bömmel F, de Man RA, Wedemeyer H, Deterding K, Petersen J, Buggisch P, et al. Long-term efficacy of tenofovir monotherapy for hepatitis B virus-monoinfected patients after failure of nucleoside/nucleotide analogues. Hepatology. 2010;51:73–80.
  53. Berg T, Marcellin P, Zoulim F, Moller B, Trinh H, Chan S, Suarez E,et al. Tenofovir is effective alone or with emtricitabine in adefovir-treated patients with chronic-hepatitis B virus infection. Gastroenterology. 2010;139:1207–17.
  54. Curtis M, Hinkle J, Harris J, Borroto-Esoda K, Zhu Y. Tenofovir is equally active in vitro against wild-type HBV clinical isolates of genotypes A-H. Hepatology. 2008;48(Suppl):735A.
  55. Marcellin P, Buti M, Krastev Z, Gurel S, Di Bisceglie AM, Odin JA, et al. Continued efficacy and safety through 4 years of tenofovir disoproxil fumarate (TDF) treatment in HBeAg-negative patients with chronic hepatitis B (study 102): preliminary analysis. Hepatology. 2010;52(Suppl):555A.
  56. Lazzarin A, Johnson M, Ribera E, Weitner L, Chen SS, Warren DR. The 5-year safety and efficacy of the once-daily antiretroviral-naïve patient regimen of efavirenz (EFV)/emtricitabine (FTC)/tenofovir DF (TDF). Proceedings of the 10th International Congress on Drug Therapy in HIV Infection, November 7–11, 2010, Glasgow, UK, abstract P6.
  57. Madruga JV, Cassetti I, Etzel A, Suleiman J, Zhou Y, Warren DR. The 10-year safety and efficacy of tenofovir DF (TDF)-containing HAART in antiretroviral naïve patients. Proceeding s of the 10th International Congress on Drug Therapy in HIV Infection, November 7–11, 2010, Glasgow, UK, abstract P86.
  58. Liaw YF, Sheen IS, Lee CM, Akarca US, Papatheodoridis GV, Suet-Hing Wong F, Chang TT, et al. Tenofovir disoproxil fumarate (TDF), emtricitabine/TDF, and entecavir in patients with decompensated chronic hepatitis B liver disease. Hepatology. 2011;53:62–72.

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