Hepatitis B-associated fibrosis and fibrosis/cirrhosis regression with nucleoside and nucleotide analogs

Abstract

Hepatitis B virus (HBV) infection currently accounts for approximately 600,000 deaths per year resulting from progression of liver fibrosis to cirrhosis and hepatocellular carcinoma. Treatment of chronic hepatitis B with antiviral agents aims to improve survival through the reduction of HBV DNA to undetectable levels and the resultant prevention of disease progression. In recent years, observations in various disease areas have shown that liver fibrosis can be reversed if the underlying cause of the liver damage is effectively addressed. In line with these observations, there is now considerable evidence to suggest that effective sustained suppression of HBV replication with long-term anti-HBV treatment can result in measurable improvements in liver fibrosis over time, even in patients with advanced cirrhosis. This review article provides an overview of currently available data on regression of fibrosis and cirrhosis in patients with chronic hepatitis B treated with nucleoside and nucleotide analog inhibitors of HBV.

Keywords::

• adefovir
• chronic hepatitis B
• cirrhosis
• entecavir
• fibrosis
• hepatitis B virus
• lamivudine
• telbivudine
• tenofovir

Financial & competing interests disclosure

Z Goodman has received research grant support from GlaxoSmithKline, Gilead Sciences, Bristol–Myers Squibb, Idenix and Novartis. A Brown has participated on Advisory Boards and/or Speaker Bureau and is a clinical trial investigator for Bristol–Myers Squibb, Gilead Sciences, Novartis, Roche, MSD and Jansenn. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing assistance was utilized in the production of this manuscript. Medical writing assistance was provided by Esther Race of ArticulateScience, supported by Bristol–Myers Squibb.