Clin Mol Hepatol.  2013 Sep;19(3):195-209. 10.3350/cmh.2013.19.3.195.

Options for the management of antiviral resistance during hepatitis B therapy: reflections on battles over a decade

• Yim HJ
• Hwang SG

• KMID: 1705199
• DOI: http://doi.org/10.3350/cmh.2013.19.3.195

Abstract

Although much advancement has been achieved in the treatment of chronic hepatitis B, antiviral resistance is still a challenging issue. Previous generation antiviral agents have already developed resistance in a number of patients, and it is still being used especially in resource limited countries. Once antiviral resistance occurs, it predisposes to subsequent resistance, resulting in multidrug resistance. Therefore, prevention of initial antiviral resistance is the most important strategy, and appropriate choice and modification of therapy would be the cornerstone in avoiding treatment failures. Until now, management of antiviral resistance has been evolving from sequential therapy to combination therapy. In the era of tenofovir, the paradigm shifts again, and we have to decide when to switch and when to combine on the basis of newly emerging clinical data. We expect future eradication of chronic hepatitis B virus infection by proper prevention and optimal management of antiviral resistance.

Keyword

Antiviral resistance; Chronic hepatitis B; Hepatitis B virus; Treatment; Nucleoside analogue; Nucleotide analogue

MeSH Terms

Adenine/analogs & derivatives/pharmacology/therapeutic use
Antiviral Agents/pharmacology/*therapeutic use
Drug Resistance, Viral/drug effects
Drug Therapy, Combination
Hepatitis B virus/genetics
Hepatitis B, Chronic/*drug therapy/prevention & control
Humans
Mutation
Nucleosides/*chemistry/pharmacology/therapeutic use
Organophosphonates/pharmacology/therapeutic use
Virus Replication/drug effects
Adenine
Antiviral Agents
Nucleosides
Organophosphonates