Antiviral therapy and regression of liver fibrosis at chronic hepatitis B
Abstract
The aim of review. Studying of effect of antiviral therapy on regression of fibrosis in chronic hepatitis B.
Original positions. Article presents analysis of the largest investigations estimating effect of interferon α and nucleoside/nucleotide analogues on development of liver fibrosis. Decrease of severity of fibrosis (for prophylaxis of liver cirrhosis and hepatocellular carcinoma development) is one of the basic criteria of efficacy of treatment of chronic liver diseases. Now various strategies of influence on fibrosis are discussed, including elimination of etiological factor, suppression of inflammation and specific antifibrotic therapy.
Conclusion. Successful antiviral therapy at chronic hepatitis B (continuous suppression of replication of virus and activity of inflammation in the liver) results in regression of fibrosis, including cirrhotic stage, and is associated with improvement of patients’ survival rate.
References
1. Albanis E., Friedman S.L. Hepatic fibrosis. Pathogenesis and principles of therapy // Clin. Liver Dis. – 2001. – Vol. 5. – P. 315–334.
2. Bedossa P., Poynard T. The French METAVIR Cooperative Study Group. An algorithm for grading activity in chronic hepatitis C // Hepatology. – 1996. – Vol. 24. – P. 289–293.
3. Castera L., Forns X., Alberti A. Non-invasive evaluation of liver fibrosis using transient elastography // J. Hepatol. – 2008. – Vol. 48, N 5. – P. 835–847.
4. Chang T.T., Gish R.G., de Man R. et al. A comparison of entecavir and lamivudine for HBeAg positive chronic hepatitis B // N. Engl. J. Med. – 2006. – Vol. 354. – P. 1001–1010.
5. Friedman S.L., Bansal M.B. Reversal of hepatic fibrosis – fact or fantasy? // Hepatology. – 2006. – Vol. 43, N 2 (suppl. 1). – P. 82–88.
6. Gish R., Lok A.S., Chang T.T. et al. Entecavir therapy for up to 96 weeks in patients with HBeAg-positive chronic hepatitis B // Gastroenterology. – 2007. – Vol. 133. – P. 1437–1444.
7. Hadziyannis S.J., Tassopoulos N.C., Heathcote E.J. et al. Adefovir dipivoxil for the treatment of hepatitis B e antigen-negative chronic hepatitis B // N. Engl. J. Med. – 2003. – Vol. 348. – P. 800–807.
8. Hadziyannis S.J., Tassopoulos N.C., Heathcote E.J. et al. Long-term therapy with adefovir dipivoxil for HBeAg-negative chronic hepatitis B for up to 5 years // Gastroenterology. – 2006. – Vol. 131. – P. 1743–1751.
9. Hui C.K., Leung N., Shek T.W. et al. Sustained disease remission after spontaneous HBeAg seroconversion is associated with reduction in fibrosis progression in chronic hepatitis B Chinese patients // Hepatology. – 2007. – Vol. 46, N 3. – P. 690–698.
10. Ishak K., Baptista A., Bianchi L. et al. Histological grading and staging of chronic hepatitis // J. Hepatol. – 1995. – Vol. 22. – P. 696–699.
11. Knodell R.G., Ishak K.G., Black W.C. et al. Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis // Hepatology. – 1981. – Vol. 4. – P. 431–435.
12. Lai C.L., Chang T.T., Chao Y.C. et al. Continued virological and biochemical Improvement through 96 weeks of Entecavir treatment in HBeAg negative chronic hepatitis B // APASL, 2006.
13. Lai C.L., Gane E., Liaw Y.F. et al. Telbivudine versus lamivudine in patients with chronic hepatitis B // N. Engl. J. Med. – 2007. – Vol. 357. – P. 2576–2588.
14. Lai C.L., Shouval D., Lok A.S. et al. Entecavir versus lamivudine for patients with HBeAg negative chronic hepatitis B // N. Engl. J. Med. – 2006. – Vol. 354. – P. 1011–1020.
15. Liaw Y.F., Chang T.T. Wu S.S. et al. Long-term entecavir therapy results in reversal of fibrosis/cirrhosis and continued histologic improvement in patients with HBeAg(+) and (–) chronic hepatitis B: results from studies ETV-022, – 027 and – 901 // Hepatology. – 2008. – Vol. 48 (suppl. 1). – P. 706A (abstract 894).
16. Liaw Y.F., Gane E., Leung N. et al. 2-Year GLOBE trial results: telbivudine Is superior to lamivudine in patients with chronic hepatitis B // Gastroenterology. – 2009. – Vol. 136, N 2. – P. 486–495.
17. Liaw Y.F., Sung J.Y., Chow W.C. et al. Lamivudine for patients with chronic hepatitis B and advanced liver disease // N. Engl. J. Med. – 2004. – Vol. 351. – P. 1521–1531.
18. Lin S.M., Yu M.L., Lee C.M. et al. Interferon therapy in HBeAg positive chronic hepatitis reduces progression to cirrhosis and hepatocellular carcinoma // J. Hepatol. – 2007. – Vol. 46, N 1. – P. 45–52.
19. Marcellin P., Chang T.T., Lim S.G. et al. Adefovir dipivoxil for the treatment of hepatitis B e antigen-positive chronic hepatitis B // N. Engl. J. Med. – 2003. – Vol. 348. – P. 808–816.
20. Mochida S., Takaguchi K., Yokosuka O. et al. Long term efficacy, safety and resistance analyses of entecavir treatment in Japanese nucleoside-naive patients with chronic hepatitis B // J. Hepatol. – 2008. – Vol. 48 (suppl. 2). – P. 262.
21. Mommeja-Marin H., Mondou E., Blum M.R., Rousseau F. Serum HBV DNA as a marker of efficacy during therapy for chronic 3HBV infection: analysis and review of the literature // Hepatology. – 2003. – Vol. 37, N 6. – P. 1309–1319.
22. Papatheodoridis G.V., Petraki K., Cholongitas E. et al. Impact of interferon-alpha therapy on liver fibrosis progression in patients with HBeAg-negative chronic hepatitis B // J. Viral Hepat. – 2005. – Vol. 12, N 2. – P. 199–206.
23. Tenney D.J., Pokornovski K.A., Rose R.E. et al. Entecavir maintains a high genetic barrier to HBV resistance through 6 years in naпve patients // J. Hepatol. – 2009. – Vol. 50 (suppl. 1). – P. 10.
24. Yoon S.K., Jang J.W., Kim C.W. et al. Long-term results of lamivudine monotherapy in Korean patients with HBeAg-positive chronic hepatitis B: response and relapse rates, and factors related to durability of HBeAg seroconversion // Intervirology. – 2005. – Vol. 48, N 6. – P. 341–349.
Review
For citations:
Abdurakhmanov D.T. Antiviral therapy and regression of liver fibrosis at chronic hepatitis B. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2010;20(1):14-20. (In Russ.)