Antiviral Agents ; therapeutic use ; Hepatitis C ; drug therapy ; Humans ; Liver Cirrhosis ; drug therapy ; virology

OBJECTIVETo review the development, mechanism, necessity and limitation of antiviral therapy in decompensated hepatitis B virus-related cirrhosis.

DATA SOURCESMost information was pulled from a literature search (Pubmed 2000 to 2011) using the keywords of antiviral and decompensated hepatitis B virus-related cirrhosis. Relevant book chapters were also reviewed.

STUDY SELECTIONWell-controlled, prospective landmark studies and review articles on antiviral therapy in decompesated hepatitis B virus-related cirrhosis were selected.

RESULTSSpecific antiviral agents not only control viral replication, which permits liver transplantation, but also improve liver function so significantly that patients could be removed from the transplant waiting list. However, the emergence of drug-resistant mutants can result in treatment failure. Combination therapy is a save-strategy in drug-resistant.

CONCLUSIONSAlthough the treatment of end-stage liver disease is still a challenge worldwide, antiviral therapy has altered the natural history of hepatitis B patients with decompensated cirrhosis. The approval of the new generation of antivirals is opening new perspectives for finding the optimal antiviral treatment for patients with decompensated cirrhosis and preventing antiviral resistance. A combination of antivirals may be one of the future strategies for fulfilling these goals.

Antiviral Agents ; therapeutic use ; Hepatitis B virus ; drug effects ; pathogenicity ; Humans ; Liver Cirrhosis ; drug therapy ; virology

Antiviral Agents ; therapeutic use ; Hepatitis B virus ; Humans ; Liver Cirrhosis ; drug therapy ; virology

Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Hepatitis B, Chronic ; complications ; drug therapy ; virology ; Humans ; Lamivudine ; adverse effects ; therapeutic use ; Liver Cirrhosis ; drug therapy ; virology

A 47-yr-old man with hepatitis B virus associated liver cirrhosis was admitted to our hospital with diarrhea and generalized edema and diagnosed as protein-losing enteropathy due to intestinal lymphangiectasia by intestinal biopsy and 99mTc albumin scan. During hospitalization, he received subcutaneous octreotide therapy. After 2 weeks of octreotide therapy, follow-up albumin scan showed no albumin leakage, and the serum albumin level was sustained. We speculate that liver cirrhosis can be a cause of intestinal lymphangiectasia and administration of octreotide should be considered for patients with intestinal lymphangiectasia whose clinical and biochemical abnormalities do not respond to a low-fat diet.
Adolescent ; Adult ; Duodenum/pathology ; Female ; Hepatitis B/complications ; Hepatitis B Virus/metabolism ; Human ; Intestinal Diseases/*drug therapy/virology ; Jejunum/pathology ; Liver Cirrhosis/*drug therapy/virology ; Lymphangiectasis, Intestinal/*drug therapy/virology ; Male ; Middle Aged ; Octreotide/*pharmacology ; Protein-Losing Enteropathies/*drug therapy

Chronic hepatitis C infection is an important cause of cirrhosis and hepatocellular carcinoma (HCC). Antiviral therapy (AVT) for patients with cirrhosis due to hepatitis C may retard the progression of cirrhosis and prevent both the development of HCC as well as the recurrence of hepatitis C following liver transplantation. This review highlights the issues associated with AVT for patients with compensated and decompensated cirrhosis due to hepatitis C virus.
Antiviral Agents ; therapeutic use ; Carcinoma, Hepatocellular ; prevention & control ; virology ; Disease Progression ; Hepacivirus ; Hepatitis C, Chronic ; complications ; drug therapy ; Humans ; Liver Cirrhosis ; drug therapy ; virology ; Liver Neoplasms ; prevention & control ; virology ; Liver Transplantation ; Secondary Prevention

Antiviral Agents ; therapeutic use ; Glomerulonephritis ; drug therapy ; virology ; Hepacivirus ; drug effects ; pathogenicity ; Humans ; Interferons ; therapeutic use ; Liver Cirrhosis ; complications ; virology ; Male ; Middle Aged ; Ribavirin ; therapeutic use

Antiviral Agents ; therapeutic use ; Hepatitis B virus ; Humans ; Interferon-alpha ; therapeutic use ; Liver Cirrhosis ; drug therapy ; virology ; Nucleosides ; therapeutic use

OBJECTIVETo study the hepatitis B virus (HBV) genotype and its relation to clinical degree and responsiveness to antiviral therapy on hepatitis in order to guide the clinical therapy.

METHODSWe amplified HBV S gene by polymerase chain reaction (PCR), using the second-round PCR product, which was digested by restriction fragment length polymorphism (RFLP). This genotype method was designed under the analysis of the restriction fragment length polymorphism and using the restriction enzymes that identified the genotype-specific sequences. Five restriction enzymes, Hph I , Nci I , Alw I, Ear I and NlaIV, were identified in genotype-specific RFLP from the S gene region. Representative sequences from the S genome region of each HBV genotype were aligned to show the restriction sites by the five restriction enzymes. The amplified S gene nucleotide sequences were sequenced by dideoxy-chain-termination method and the corresponding amino acid sequence was deduced using DNASIS software. Later, they were genotyped by comparing to representative S gene sequences obtained from GenBank. This confirmed the results of RFLP HBV genotyping methods, coincident with that of S gene sequence.

RESULTSGenotypes A, B, C, D were classified in 216 patients with HBV and DNA positive. The results showed that: 1 case (0.46%) of genotype A, 19 cases genotype B (8.8% ), 175 genotype C (81.02%) and 21 genotype D (9.72%). A total of 86 patients in the hospital were divided into either genotype C cases (69) or non-genotype C cases (17).

CONCLUSIONGenotype C was the major genotype in Changchun. Among HBV patients, type C was 80.95%, followed by genotypes B and D. Both hepatocellular carcinoma and liver cirrhosis showed relations with genotype C.

Antiviral Agents ; pharmacology ; Carcinoma, Hepatocellular ; virology ; Drug Resistance, Viral ; Genotype ; Hepatitis B ; drug therapy ; Hepatitis B virus ; classification ; drug effects ; genetics ; Humans ; Liver Cirrhosis ; virology ; Liver Neoplasms ; virology ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length

Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; complications ; drug therapy ; virology ; Humans ; Lamivudine ; therapeutic use ; Liver Cirrhosis ; drug therapy