What are the currently effective drugs for the treatment of hepatitis B?
What are the currently effective anti-hepatitis B drugs? How to choose medication?
New progress in the treatment of chronic hepatitis B
1. Treatment goal: to prevent the development of liver lesions by inhibiting hepatitis B virus replication or eliminating infection. The specific manifestations are: ① Negative serum HBV DNA; ② Serum HBeAg was negative and anti-HBe was positive (that is, the "big three yangs" turned into "small three yangs"); ③ serum ALT was normal; ④ liver histology improved.
2. Indications for antiviral treatment: serum HBVDNA or/and HBeAg positivity lasts for more than 6 months; serum ALT level rises repeatedly; liver histological examination shows chronic infection with hepatitis B virus, and the degree of inflammation is moderate or above .
3. Effective anti-hepatitis B virus drugs:
3.1a-Interferon:
In 1992, the US Food and Drug Administration (FDA) approved a- Interferon is used to treat patients with chronic hepatitis B. It has the functions of inhibiting viral replication and enhancing immunity. The recommended dose is 5 million units per subcutaneous injection, three times a week, and the course of treatment is at least 6 months. Such drugs currently include the imported drugs "Interference Energy", "Luosu", and "Huifuren" and the domestic drugs "Saruojin", "Yundesu", "Andafen", "Interfen", etc.
Indicators of good efficacy include: serum HBVDNA level before treatment is lower than 200pg/mL, serum ALT is above 100U/L, liver histological examination shows obvious inflammatory activity, female, and has a history of acute hepatitis in the medical history, The virus lasts for a short period of time, is not transmitted from mother to child, and does not mutate.
Possible adverse reactions include: cold-like symptoms, bone marrow suppression (shown as a decrease in peripheral blood white blood cell count and platelet count), loss of appetite, weight loss, hair loss, mental depression, etc.
3.2 Lamivudine:
Lamivudine (trade name in my country is "Hepudin") was approved by the US FDA in December 1998 for the treatment of hepatitis B virus. Another drug only has the function of inhibiting viral replication. The recommended treatment plan is 100 mg orally, once a day, and the treatment course is at least 1 year.
Possible adverse reactions: No obvious adverse reactions have been found so far.
Note: Virus mutation needs to be checked after 9 months of treatment to prevent the occurrence of drug resistance
3.3 Famciclovir:
Famciclovir (trade name: "Livzon" "Wind") is another type of nucleoside analogue with a mechanism of action similar to lamivudine. The recommended regimen is 0.5g orally administered three times a day, with a course of treatment of at least 4 months.
3.4 Immunomodulator:
Thymosin a1 (trade name: "Ridaxian") is an immune enhancer that exerts an antiviral effect by enhancing immunity to hepatitis B virus. It is generally used in combination with alpha-interferon or lamivudine. The recommended regimen is subcutaneous injection of 1.6 mg each time, once a day, and then changed to twice a week after 4 consecutive days. The course of treatment is 4-6 months.
4. Notes: Monitor serum ALT, HBVDNA, HBeAg/anti-HBe during treatment, and treat under the guidance of a professional physician.