核苷（酸）类似物（ nucleos （t） ide analogue，NA）类药物是目前临床治疗慢性乙型肝炎（chronic hepatitisB，CHB）的重要药物。该类药物凭借其强大的病毒复制抑制能力、服用简便和副作用小等优势得到广泛应用，在控制疾病向终末期...核苷（酸）类似物（ nucleos （t） ide analogue，NA）类药物是目前临床治疗慢性乙型肝炎（chronic hepatitisB，CHB）的重要药物。该类药物凭借其强大的病毒复制抑制能力、服用简便和副作用小等优势得到广泛应用，在控制疾病向终末期肝病进展方面发挥积极有效的作用。然而，随着该类药物的长期使用，乙型肝炎病毒（hepatitis B virus，HBV）发生耐药变异的危险性也随之增加，目前认为发生耐药变异是引起NAs治疗失败的最重要的影响因素之一。展开更多
Nucleos(t)ide analogues(NA) are a breakthrough in the treatment and management of chronic hepatitis B.NA could suppress the replication of hepatitis B virus(HBV) and control the progression of the disease.However,drug...Nucleos(t)ide analogues(NA) are a breakthrough in the treatment and management of chronic hepatitis B.NA could suppress the replication of hepatitis B virus(HBV) and control the progression of the disease.However,drug resistance caused by their long-term use becomes a practical problem,which influences the long-term outcomes in patients.Liver transplantation is the only choice for patients with HBV-related end-stage liver disease.But,the recurrence of HBV after transplantation often caused by the development of drug resistance leads to unfavorable outcomes for the recipients.Recently,the multi-drug resistance(MDR) has become a common issue raised due to the development and clinical application of a variety of NA.This may complicate the antiviral therapy and bring poorly prognostic outcomes.Although clinical evidence has suggested that combination therapy with different NA could effectively reduce the viral load in patients with MDR,the advent of new antiviral agents with high potency and high genetic barrier to resistance brings hope to antiviral therapy.The future of HBV researches relies on how toprevent the MDR occurrence and develop reasonable and effective treatment strategies.This review focuses on the diagnostic and therapeutic progress in MDR caused by the anti-HBV NA and describes some new research progress in this field.展开更多
文摘核苷（酸）类似物（ nucleos （t） ide analogue，NA）类药物是目前临床治疗慢性乙型肝炎（chronic hepatitisB，CHB）的重要药物。该类药物凭借其强大的病毒复制抑制能力、服用简便和副作用小等优势得到广泛应用，在控制疾病向终末期肝病进展方面发挥积极有效的作用。然而，随着该类药物的长期使用，乙型肝炎病毒（hepatitis B virus，HBV）发生耐药变异的危险性也随之增加，目前认为发生耐药变异是引起NAs治疗失败的最重要的影响因素之一。
文摘Nucleos(t)ide analogues(NA) are a breakthrough in the treatment and management of chronic hepatitis B.NA could suppress the replication of hepatitis B virus(HBV) and control the progression of the disease.However,drug resistance caused by their long-term use becomes a practical problem,which influences the long-term outcomes in patients.Liver transplantation is the only choice for patients with HBV-related end-stage liver disease.But,the recurrence of HBV after transplantation often caused by the development of drug resistance leads to unfavorable outcomes for the recipients.Recently,the multi-drug resistance(MDR) has become a common issue raised due to the development and clinical application of a variety of NA.This may complicate the antiviral therapy and bring poorly prognostic outcomes.Although clinical evidence has suggested that combination therapy with different NA could effectively reduce the viral load in patients with MDR,the advent of new antiviral agents with high potency and high genetic barrier to resistance brings hope to antiviral therapy.The future of HBV researches relies on how toprevent the MDR occurrence and develop reasonable and effective treatment strategies.This review focuses on the diagnostic and therapeutic progress in MDR caused by the anti-HBV NA and describes some new research progress in this field.
