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İstanbul Medical Journal
| İstanbul Med J. 2017; 18(4): 0-0 | |||
Chronic hepatitis B treatment: current perspectives on telbivudineGian Paolo Caviglia1, Chiara Rosso1, Antonella Olivero1, Maria Lorena Abate1, Rinaldo Pellicano2, Antonina Smedile21Department of Medical Sciences, University of Turin, Turin, Italy2Department of Gastroenterology, Città della Salute e della Scienza, Turin, Italy Hepatitis B virus (HBV) is the second cause of chronic viral hepatitis worldwide. Currently, there are 5 oral nucleos(t)ide analogues (NAs) approved for chronic hepatitis B (CHB) treatment and include lamivudine, adefovir, telbivudine (LtD), entecavir (ETV) and tenofovir (TDF). ETV and TDF are those with higher antiviral efficacy and lower resistance rates whereas LtD showed similar efficacy but higher risk for viral resistance in long-term monotherapy. However, LtD carries several advantages that must be considered and deserve to be discussed. Compared to other NAs, LtD showed a potential renal protective effect particularly in patients with mild renal insufficiency. Moreover, several data suggest that LtD could be safely administered in highly viremic pregnant women in order to reduce vertical transmission risk despite vaccination and HB immunoglobulin prophylaxis. In addition, reported adverse events are rare, usually transitory with patients’ recovery after treatment cessation. Finally, the lower cost and the easy availability compared to ETV and TDF make LtD a valid first-line alternative for CHB treatment in economically less developed regions. Anahtar Kelimeler: Antiviral treatment, chronic HBV infection, HBV, nucleos(t)ide analogueChronic hepatitis B treatment: current perspectives on telbivudineGian Paolo Caviglia1, Chiara Rosso1, Antonella Olivero1, Maria Lorena Abate1, Rinaldo Pellicano2, Antonina Smedile21Department of Medical Sciences, University of Turin, Turin, Italy2Department of Gastroenterology, Città della Salute e della Scienza, Turin, Italy Hepatitis B virus (HBV) is the second cause of chronic viral hepatitis worldwide. Currently, there are 5 oral nucleos(t)ide analogues (NAs) approved for chronic hepatitis B (CHB) treatment and include lamivudine, adefovir, telbivudine (LtD), entecavir (ETV) and tenofovir (TDF). ETV and TDF are those with higher antiviral efficacy and lower resistance rates whereas LtD showed similar efficacy but higher risk for viral resistance in long-term monotherapy. However, LtD carries several advantages that must be considered and deserve to be discussed. Compared to other NAs, LtD showed a potential renal protective effect particularly in patients with mild renal insufficiency. Moreover, several data suggest that LtD could be safely administered in highly viremic pregnant women in order to reduce vertical transmission risk despite vaccination and HB immunoglobulin prophylaxis. In addition, reported adverse events are rare, usually transitory with patients’ recovery after treatment cessation. Finally, the lower cost and the easy availability compared to ETV and TDF make LtD a valid first-line alternative for CHB treatment in economically less developed regions. Keywords: Antiviral treatment, chronic HBV infection, HBV, nucleos(t)ide analogueGian Paolo Caviglia, Chiara Rosso, Antonella Olivero, Maria Lorena Abate, Rinaldo Pellicano, Antonina Smedile. Chronic hepatitis B treatment: current perspectives on telbivudine. İstanbul Med J. 2017; 18(4): 0-0 Sorumlu Yazar: Gian Paolo Caviglia, Italy |
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