A 1-Year Trial of Telbivudine, Lamivudine, and the Combination in Patients With Hepatitis B e Antigen—Positive Chronic Hepatitis B

Lai, Ching–Lung; Leung, Nancy; Teo, Eng–Kiong; Tong, Myron J.; Wong, Florence; Hann, Hie‐Won; Han, Steven; Poynard, Thierry; Myers, Maureen; Chao, George; Lloyd, Deborah; Brown, Nathaniel

doi:10.1053/j.gastro.2005.05.053

Cited by 191 publications

(155 citation statements)

References 25 publications

Supporting

Mentioning

137

Contrasting

Unclassified

Order By: Relevance

“…Telbivudine suppresses wild-type HBV by 5-8 log 10 and was more potent than lamivudine in a Phase II study. 161 Clevudine 30 mg/day for 24 weeks resulted in an HBV DNA reduction of 4.46 log 10 undetectable by PCR in 59%, HBeAg loss in 24%, and ALT normalization in 76%. 162 Tenofovir disoproxil fumarate show strong suppression of HBV with YMDD motif mutants and has a good safety record.…”

Section: Other Antiviral Agentsmentioning

confidence: 93%

Update of research and management of hepatitis B

Okanoue¹,

Minami²

2006

J Gastroenterol

View full text Add to dashboard Cite

and the mutation of precore and core promoter regions. 7,23 Most HBV carriers in Asian countries have resulted from maternal transmission of the infection during early childhood, and around 80% of the carriers show natural seroconversion from a hepatitis B e antigen (HBeAg)-positive state to an HBe antibody (HBeAb)-positive state before 25 years of age. Furthermore, HBeAg to HBeAb seroconversion frequently occurs in chronic hepatitis patients with a high serum alanine aminotransferase (ALT) level. Thus, it is important to clarify the natural course of HBV carriers before antiviral treatment. This article focuses on the recent advances in basic research of HBV and suggests a strategy of antiviral therapy for chronic hepatitis B patients. HBV genotypeThere are currently eight HBV subgroups based on genetic differences. HBV genotypes A, B, C, and D were first classified by an intergroup divergence of more than 8%. 1 HBV genotypes E and F were then identified, 2 followed by recent reports of genotypes G and H. 3,4 One cannot discriminate these genotypes by four serological subtypes (adw, adr, ayw, ayr) of HBV, which are classified by antigenic determinants of the hepatitis B surface antigen, but a there is a partial correlation between genotypes and serotypes (Table 1). There are also a few reports on a serological method for determining HBV genotypes using several monoclonal antibodies to preS2 and S proteins. 24,25 These HBV genotypes show a close relation to ethnicity (Table 1); more importantly, recent investigations have revealed associations between HBV genotypes and clinical features of the infection.Two major genotypes, HBV/B and HBV/C, prevail in East Asia including Japan. HBV genotype C was more prevalent than genotype B in cirrhotic patients in Japan, 5,26 China, 27 and Taiwan. 28 Another study from

show abstract

Section: Other Antiviral Agentsmentioning

confidence: 93%

Update of research and management of hepatitis B

Okanoue¹,

Minami²

2006

J Gastroenterol

View full text Add to dashboard Cite

show abstract

“…The combination of lamivudine with telbivudine also showed no benefit compared to a monotherapy with either drug in this setting [44]. However, in immune-tolerant patients with a mean viral load >8 log 10 IU/ml, stronger suppression of HBV DNA to undetectable levels after 192 weeks was found in patients receiving tenofovir plus emtricitabine as compared to those receiving tenofovir alone (76 vs. 55%; p = 0.011) [19].…”

Section: Combination Treatments Beyond Resistance Managementmentioning

confidence: 99%

Antiviral Therapy of Chronic Hepatitis B

Bömmel

Berg²

2014

Intervirology

View full text Add to dashboard Cite

Since the licensing of lamivudine in 1999, the treatment of chronic hepatitis B has been revolutionized by the introduction of oral nucleoside and nucleotide analogues (NAs), which act as inhibitors of the HBV polymerase. The effectiveness of the first of these substances was limited by incomplete response and resistance development in many patients, but today, highly potent substances are available that make a reliable and durable suppression of HBV replication, a reduction of necroinflammatory activity in the liver, and even a reversion of liver fibrosis achievable for almost all patients. Beyond that, NA treatment can prevent the development of hepatocellular carcinoma in many patients. HBeAg seroconversion appears in approximately 50% of all HBeAg-positive patients during NA treatment. However, the ideal treatment endpoint, the serologic loss of HBsAg, remains a rare event almost exclusively achievable for HBeAg-positive patients. After cessation of the treatment, HBV replication tends to relapse in most patients, which is why the duration of NA treatment is indefinite. Future treatment strategies should aim at tailoring individual NA treatment regimens to increase HBs loss rates and optimize treatment duration.

show abstract

“…The effect of antiviral drugs in chronic hepatitis B patients is determined by the on-treatment effect or a sustained response. Different RCTs have shown that antiviral treatment leads to the improvement of one or more intermediate parameters, also regarded as surrogate markers or prognostic markers, in variable numbers of chronic hepatitis B patients; these parameters include decreased levels of HBV DNA, normalization of ALT, seronegativity of HBeAg, development of anti-HBe, clearance of HBsAg, expression of anti-HBs, decreased liver inflammation, and containment of liver fibrosis [5][6][7][8][9][10]. However, a conclusive positive impact of antiviral drugs on all intermediate parameters has not been shown.…”

Section: Ongoing Regimens Of Antiviral Therapy Against Chronic Hepatimentioning

confidence: 99%

“…Much optimism has surrounded the use of antiviral therapy because the powerful drugs that have been developed during the past decade can effectively block HBV replication in a considerable number of patients with chronic hepatitis B. Furthermore, antiviral drugs lead to the normalization of alanine aminotransferase (ALT) levels, decrease liver inflammation and hepatic fibrosis, and induce seronegativity and/or seroconversion of hepatitis B e antigen (HBeAg) and hepatitis B surface antigen (HBsAg) in many chronic hepatitis B patients [5][6][7][8][9][10]. Randomized controlled trials (RCTs) with antiviral drugs in patients with chronic hepatitis B have shown considerable improvements in some intermediate parameters that have long been regarded as surrogate markers of the clinical outcome of HBV infection in these patients.…”

Section: Introductionmentioning

confidence: 99%

Future aspects of therapy for hepatitis B virus infection: value of surrogate markers, innovative therapy, and global collaboration

2011

View full text Add to dashboard Cite

Both optimism and frustration exist regarding therapy for patients with chronic hepatitis B virus infection. Due to the recent advent of several drugs with potent antiviral capacities and comparatively low rates of adverse effects, considerable optimism has developed regarding the treatment of these patients. Chronic hepatitis B is now a treatable disease, and suppression of hepatitis B virus replication, normalization of alanine aminotransferase levels, seronegativity/seroconversion of hepatitis B e antigen and hepatitis B surface antigen, and decreased hepatic inflammation and liver fibrosis have been documented in chronic hepatitis B virus-infected patients treated with antiviral therapy. In contrast, many frustrations regarding antiviral therapy for chronic hepatitis B have arisen, because the disease, although treatable, is not curable. The present regimens of antiviral therapy modulate some intermediate parameters or so-called surrogate markers in chronic hepatitis B virus-infected patients, but usually fail to improve all intermediate parameters or ultimate clinical outcomes. In addition, major concerns remain about the applicability and use of antiviral drugs in developing and resource-constrained countries in which healthcare delivery systems do not support the proper use of antiviral therapy. New and more effective therapeutic regimens for chronic hepatitis B patients are needed that take into account potential surrogate markers of treatment outcomes and allow for effective collaboration between resource-constrained and advanced countries.

show abstract

A 1-Year Trial of Telbivudine, Lamivudine, and the Combination in Patients With Hepatitis B e Antigen—Positive Chronic Hepatitis B

Cited by 191 publications

References 25 publications

Update of research and management of hepatitis B

Update of research and management of hepatitis B

Antiviral Therapy of Chronic Hepatitis B

Future aspects of therapy for hepatitis B virus infection: value of surrogate markers, innovative therapy, and global collaboration

Contact Info

Product

Resources

About