Actualizări în terapia infecţiei cronice cu virusul hepatitei B.

In the past two decades there have been major developments in the treatment of chronic hepatitis B. The introduction of new antiviral therapies, current knowledge about the natural history of the infection, the contribution of molecular biology to define multiple mutations in the HBV genome have imposed changes in therapeutic strategy lines. Hepatitis B virus (HBV) is a small DNA virus characterized by a high viremia and infectivity The virus is capable of integrating into the cell genome and hepatocellular damage is determined by the host's immune response not by the virus cytopathic effect. It is estimated that over 2 billion people have been exposed to HBV, chronic HBV infection affects more than 350 million people worldwide. Patients with chronic infection have a high risk of progression to cirrhosis and hepatocellular carcinoma (HCC). The goal of antiviral treatment is to prevent disease progression to cirrhosis and/or HCC. In deciding regarding interferon therapy or with nucleoside/nucleotide analogs (NAs), we should examine the relative merits and limitations of each strategy. The main advantage of the interferon therapy is the finite course of treatment and high durability. NAs are administered orally and have fewer side effects. [ABSTRACT FROM AUTHOR]