Experience with Lamivudine against Hepatitis B Virus
作者:
Elmar Jaeckel,
Michael P. Manns,
期刊:
Intervirology
(Karger Available online 1997)
卷期:
Volume 40,
issue 5-6
页码: 322-336
ISSN:0300-5526
年代: 1997
DOI:10.1159/000150565
出版商: S. Karger AG
关键词: Lamivudine;Hepatitis B virus;Chronic hepatitis;Nucleoside metabolism;Resistance;Cross-resistance;Orthotopic liver transplantation;Molecular actions;Combination therapy;Famciclovir;Ganciclovir;Interferon;Immunosuppression;Human immunodeficiency virus
数据来源: Karger
摘要:
After several nucleoside analogues have been tested against chronic hepatitis B virus (HBV) infection with minimal success, lamivudine seems to be a highly effective new therapeutic option. This review focusses on nucleoside metabolism and on the molecular action of lamivudine as well as on results of clinical studies for several indications. We report on results of trials on the use of lamivudine for chronic HBV infection, chronic HBV under immunosuppression and prophylaxis or treatment of HBV reinfection before or after orthotopic liver transplantation. Aspects of combination therapy of different nucleoside analogues as well as on combination of lamivudine with interferon are also highlighted. Although lamivudine seems to be highly effective in most patients at the start of therapy, development of resistance by mutations in the viral polymerase is a significant clinical problem. The mode of resistance development is compared with the situation in HIV infection. Possible cross-resistance with other nucleoside analogues and the perspectives of lamivudine therapy are also considered.
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