Hepatitis B virus long- term impact of antiviral therapy nucleot(s)ide analogues ( NUCs)

Abstract

The goal of antiviral therapy is to improve the quality of life and survival of patients with chronic hepatitis B ( CHB ) by halting the progression to cirrhosis, end- stage liver disease or hepatocellular carcinoma ( HCC ), thus preventing anticipated liver- related death. Oral administration of potent and less resistance- prone nucleot(s)ide analogues ( NUC s), such as entecavir ( ETV ) and tenofovir disoproxil fumarate ( TDF ) has become the most popular treatment strategy worldwide because of their excellent efficacy and safety profile as well as easy management confirmed in both registration trials and in clinical practice studies. Long- term administration of ETV or TDF suppresses HBV replication in >95% of patients, resulting in biochemical remission, histological improvement including the regression of cirrhosis and prevention or reversal of clinical decompensation but not the development of HCC , particularly in patients with cirrhosis. Moreover, NUC s can be administered to all patients including those with severe liver disease, the elderly and in those who do not respond, are unwilling to take or have contraindications to interferon. The need for long- term, perhaps indefinite, treatment is the main limitation of NUC s therapy with the associated costs, unknown long- term safety and the low rates of hepatitis B surface antigen ( HB sAg) seroclearance, which is still the best stopping rule for NUC s- treated patients with cirrhosis.

 

K E Y W O R D S
cirrhosis , hepatitis B , hepatocellular carcinoma , nucleot(s)ides analogues

About Speaker

Pietro LAMPERTICO

Professor

Italy

City: Milan

Institution: Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan

Contact: pietro.lampertico@unimi.it


Biography of Pietro LAMPERTICO

Professor Pietro Lampertico is Assistant Professor in the 1st Gastroenterology Unit at the Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy, under the direction of Professor Massimo Colombo.

 

A 1986 graduate of the State University of Milan with degrees in medicine and surgery, Professor Lampertico completed his postdoctoral research in the Department of Experimental Pathology at Tulane University in New Orleans, USA. Upon his return to Milan, he completed specialisations in liver diseases and internal medicine. He received his PhD in clinical methodology from the University of Milan in 1998. In the Gastroenterology Unit, Professor Lampertico is primarily involved in the clinical management of chronic viral hepatitis outpatients, particularly those with CHB. His research interests include the treatment of patients with chronic hepatitis/cirrhosis due to HBV, the long-term outcome of cirrhotic patients undergoing antiviral treatment, and the diagnosis and management of antiviral resistance to oral nucleos(t)ide analogues.

 

Professor Lampertico is currently a reviewer for Gastroenterology, Hepatology, Gut, Journal of Hepatology and other top ranked journals, and a member of AASLD, EASL and AISF.

 

He has spoken internationally about liver disease, specifically the natural history of HBV and antiviral treatment, and has published several articles and book chapters. He is currently involved in national and international HBV clinical trials.

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