A global liver disease, the chronic hepatitis B virus (HBV) infection affects an estimated 257 million people globally. If the virus is not treated, it can result in cirrhosis, liver cancer, and progressive liver damage. The treatment of chronic HBV infection has been revolutionised by antiviral therapy, vastly improving the results for those who are infected. An overview of antiviral therapy for chronic HBV infection is the goal of this article.
Treatment Options for Chronic Hepatitis B Virus Infection
Medications that directly target the virus are used in antiviral therapy for chronic HBV infection. These medications either prevent the virus from replicating or lessen its capacity to harm the liver. The aim of treatment is to achieve long-term viral replication suppression, which lowers the risk of liver damage and the development of cirrhosis and liver cancer. There are several antiviral agents available for the treatment of chronic HBV infection, including nucleos(t)ide analogs (NAs) and interferons (IFNs).
Nucleos(t)ide analogs (NUC’s) are oral medications that inhibit viral replication by blocking the reverse transcriptase enzyme that is essential for HBV replication. They include drugs like lamivudine, adefovir, entecavir, tenofovir, and telbivudine. These medications can effectively suppress viral replication and improve liver function. However, they do not cure HBV infection and long-term treatment is often necessary to maintain viral suppression. Entehep 1mg tablet containing the active constituent entecavir is used to treat long-term hepatitis B virus (HBV) infection in adults
Interferons are proteins that can stimulate the body's immune system to fight viral infections. Pegylated interferon-alpha is the only type of interferon approved for the treatment of chronic HBV infection. It is given as a subcutaneously and can be used as a first-line therapy in some patients with hepatitis B e antigen (HBeAg)-positive or HBeAg-negative disease. Interferon therapy has a limited duration of treatment (usually 48 weeks) and can have significant side effects.
Combination therapy involves the use of two or more antiviral medications to achieve more effective viral suppression. The combination of a nucleos(t)ide analog and pegylated interferon-alpha is sometimes used to achieve a sustained response in patients with chronic HBV infection. However, this treatment approach is not without its limitations and side effects.
The degree of liver damage, the rate of viral replication, and the prevalence of drug resistance all influence the choice of antiviral therapy. Since they are typically well tolerated and carry a low risk of adverse effects, NUCs are the first-line therapy for the majority of patients. IFNs are only given to a small group of individuals who have compensating hepatic disease and normal liver function, as they have a higher risk of side effects and may not be well-tolerated by all patients.
Adherence to Treatment and the Importance of Regular Monitoring
Monitoring viral load and performing liver function tests allow for the evaluation of the antiviral medication response. An SVR is characterised by undetectable HBV DNA levels after at least six months following the end of treatment. Having an SVR is linked to better outcomes and a lower risk of disease progression.
Antiviral medication does not, however, cure persistent HBV infection, and in some patients, treatment may need to be continued continuously. Additionally, a major issue with long-term NUC therapy is the development of medication resistance. As a result, it's critical to regularly check for medication resistance; if it materialises, treatment may need to be modified.
Conclusion
Antiviral therapy is a very successful treatment for persistent HBV infection, to sum up. The degree of liver damage, the rate of viral replication, and the prevalence of medication resistance all influence the therapy of choice. It's crucial to regularly check for treatment resistance and response in order to give patients the best results possible.
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Hepatitis infection are of three types: Hepatitis A, Hepatitis B, and Hepatitis C. Hence, its treatment will also vary according to its type.
It decreases the functionality of the liver and gives result in liver failure.
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When the liver is injured, the hepatic cells at the location of the injury die off, leaving behind a mesh of connective tissue.
Normally, the liver produces new hepatic cells and attaches them to the connective tissue to heal the injury.
However, long-lasting liver injury, repetitive liver injury or inflammation may result in the formation of excessive scar tissues that causes hepatic fibrosis.
The scar tissue disrupts the normal functioning of the liver and causes structural changes in the liver.
Hepatic fibrosis may be a result of various etiologies such as:
Storage disorders such as fructosemia, galactosemia, etc
