Hepatitis B virus-related decompensated liver cirrhosis: Benefits of antiviral therapy

Cheng Yuan Peng, Rong Nan Chien, Yun Fan Liaw*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

177 Scopus citations

Abstract

Following development of liver cirrhosis in patients with chronic hepatitis B, liver disease may continue to progress and decompensation or hepatocellular carcinoma (HCC) may occur, especially in those with active viral replication. Decompensation may manifest with jaundice, ascites, variceal bleeding or hepatic encephalopathy. Earlier studies have shown that the prognosis of decompensated cirrhosis is usually poor with a 5-year survival rate at 14-35% under conventional standard of care. The approval of oral antiviral agents has greatly improved the prognosis, as demonstrated in several cohort studies and randomized clinical trials involving therapy with lamivudine, adefovir dipivoxil, entecavir, telbivudine, or tenofovir disoproxil fumarate. Oral antiviral agents are effective in restoring liver function and improving survival in patients with decompensated cirrhosis especially if therapy is initiated early enough. These agents are generally well tolerated without significant side effects. However, their preventive effect in HCC development has yet to be convincingly demonstrated. Given their known resistance profiles, entecavir and tenofovir should be considered as the first-line therapy for patients with HBV-related decompensated cirrhosis.

Original languageEnglish
Pages (from-to)442-450
Number of pages9
JournalJournal of Hepatology
Volume57
Issue number2
DOIs
StatePublished - 08 2012

Keywords

  • Antiviral therapy
  • Entecavir
  • Hepatitis flare
  • Hepatocellular carcinoma
  • Nucleos(t)ide analogues
  • Tenofovir disoproxil fumarate

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