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Semin Liver Dis 2006; 26(2): 130-141
DOI: 10.1055/s-2006-939751
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel: +1(212) 584-4662.

Hepatitis B e Antigen-Negative Chronic Hepatitis B: Natural History and Treatment

Stephanos J. Hadziyannis1 , George V. Papatheodoridis2
  • 1Department of Medicine and Hepatology, Henry Dunant Hospital, Athens, Greece
  • 2Second Department of Medicine, Athens University Medical School, Athens, Greece
Further Information

Publication History

Publication Date:
03 May 2006 (online)

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ABSTRACT

Hepatitis B e antigen (HBeAg)-negative chronic hepatitis B evolves in the natural history of chronic hepatitis B virus (HBV) infection linked with selection of nonproducing HBeAg but replication-competent HBV mutants, and may have a potentially severe and progressive course. Effective suppression of HBV replication is the main therapeutic target. Sustained off-therapy responses are rare with treatment of finite duration, except perhaps for interferon-based therapies, which induce such responses in a sizeable, yet small proportion of patients. Eventually, the majority of patients will be treated with long-term oral antiviral therapy, which improves patients' outcome but is associated with progressively increasing rates of viral resistance. The long-term resistance profile of adefovir is significantly better than that of lamivudine (LMV), whereas data for entecavir currently are limited to 2 years, with resistance developing in LMV-resistant but not in treatment-naïve patients. Combination therapy with adefovir added to LMV in LMV-resistant patients is extremely effective; cases of adefovir-resistance have not been reported to date.

KEYWORDS

Chronic hepatitis B - interferon-alfa - lamivudine - adefovir - entecavir

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 Professor
Stephanos J HadziyannisM.D. 

Department of Medicine and Hepatology, Henry Dunant Hospital

107 Messogion Avenue, 11526 Athens, Greece