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JAC Advance Access published online on April 4, 2006

Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkl123
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Leading article

Antiviral options for the treatment of chronic hepatitis B

Melissa K. Osborn 1 and Anna S. F. Lok 2 *

1 Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA; Present address. University of Michigan Medical Center, Division of Gastroenterology, 1500 E. Medical Center Drive, 3912 Taubman Center, Ann Arbor, MI 48109-0362, USA
2 Division of Gastroenterology, University of Michigan Medical Center, 1500 E. Medical Center Drive, 3912 Taubman Center, Ann Arbor, MI 48109-0362, USA

* To whom correspondence should be addressed.
Anna S. F. Lok, E-mail: aslok{at}med.umich.edu


   Abstract

Hepatitis B virus (HBV) is an important cause of end-stage liver disease and hepatocellular carcinoma. Effective treatment can delay or prevent these outcomes. The decision to treat is based on the activity of liver disease and HBV replication status, and the likelihood of a long-term benefit. Approved therapies include standard and pegylated interferon-alfa and nucleoside analogues: lamivudine, adefovir and entecavir. Current therapies do not eradicate HBV so long-term treatment is usually required. Development of drug resistance is a major concern with long-term treatment. Even with successful therapy, patients remain at risk for reactivation of viral replication and require lifelong monitoring.

Keywords: interferon; lamivudine; adefovir; entecavir; natural history.
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