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The available treatment ways of Hepatitis B

All the information contained on this informational resource is intended exclusively for practitioners and cannot be used by the site visitors for self-diagnosing and prescribing treatment without a previous consultation with the doctor.

In the treatment of viral Hepatitis (VH) AVM should act in several directions: to prevent the infection of new cells in the body and block the replication of the virus. The treatment of chronic HV (CHV), including the prevalence and progression of many forms of these diseases is one of the key problems in modern hepatology. The application of etiotropic therapy allowed not only to stop the progression of the disease in significant number of patients, but in some cases to achieve the complete cure.

The main indication for the use of AVM at any stage of the disease is the active replication of Hepatitis viruses, which are the markers for:

  • HBV - loading of HBV-DNA (PCR), HBeAg, anti-HBcor Ig M
  • HCV – loading of HCV-RNA anti-HCV Ig M

All antiviral CM (chemical medicines) used to treat the HV, belong to 3 main groups. Antiviral CM are used in the treatment of acute and chronic forms of HV. The simultaneous combined or sequential therapy drugs with three mentioned groups is appropriate. It is prospectively to use continuously for 2-3 months the two reverse transcriptase inhibitors and protease inhibitors in protracted course of acute Hepatitis, and in chronic Hepatitis – for 6-12 months depending on the nature of the activity, the extent of viraemia and the immune response.

The options of specific therapy can be an immunoglobulin with a high titer of anti HBs and recombinant vaccine against Hepatitis B. It is appropriate to use the interferons or their inducers in combination with antiviral CM.

The main groups of CM for the treatment of Hepatitis

Group 1 – the inhibitors of reverse transcriptase (RT) these medicinal substances, penetrating into the cell, inhibit the synthesis of DNA or RNA, replacing the natural nucleosides during the synthesis. The drugs of this group are divided into 3 subgroups:

  • the nucleoside analogues (they are often used in treatment of HV),
    • nucleotide analogues,
    • and dinucleotide counterparts.

Inhibitors of reverse transcriptase

Analogues of nucleosides
1. Azidothymidine (AZT, Zidovudin, Retrovir), timozid
Lamivudine (Epivir, 3TC)
Acyclovir (zovirax virolex), acycloguanosine
Famciclovir (Famvir), Vectavir, Penciclovir
Valacyclovir (Valtrex)
Ganciclovir, Cymeven, Cytovene
Lobucavir, Cygalovir
Vidarabine, Virasole
Sorivudine, Usevir

Didanosine (videx), ddI
Zacitabine (Dideoxycytidine, HIVID, ddC)

The greatest efficiency in HBV has lamivudine, AZT and famciclovir, in HCV – ribovirin, AZT.

1. Nucleotide analogues
Adefovir dipivoxil

2. Non-nucleoside analogues
Loviride (Alpha-Ara Derivatives)

Group 2 - protease Inhibitors
The drugs of this group, seeping into the affected cell, block the activity of the viral zyme - protease, which is used at the stage of virions' reproduction, thus preventing the formation of new viral particles. The protease of the virus differs from the protease of human cells, so the protease inhibitors act at random.

Group 3 - Analogues of pyrophosphate
The positive feature of protease inhibitors is that in order to activate it, in contrast to the reverse transcriptase inhibitors, the cellular metabolism is unnecessary, and, consequently, they stay effective and in the chronic infected cells.

Indinavir (Crixivan)
Saquinavir (Invirase)
Ritonavir (Norvir)
Neflinavir (Viracept)

Analogues of pyrophosphate. In the cells under the influence of zymes they are phosphorylated to the active forms. The analogues of pyrophosphate have an inhibitory effect on the virus-specific enzymes, thereby blocking the synthesis of viral DNA and disrupting the replication of the virus.

Foscarnet, Fiscavir
Antiviral medicines (ribavirin etc.) are used in combination with interferon or inducers of IFN, as well as with immunoglobulins and other drugs (A. G. Rakhmanova et al., 2007; L. S. Stratchounski et al., 2007; A. A. Yakovlev et al., 2003).

The results of antiviral therapy cannot be considered satisfactory yet. Its effectiveness depends on the genotypes (and subtypes) of HCV, the selection of mutant strains of HBV, the level of viral RNA/DNA, the activity of the inflammatory process in the liver. The interferonotherapy is an expensive one, some patients have side effects and the formation of antibodies against IFN, which reduce the effectiveness of treatment. There are contraindications to interferon, in particular drug addiction. The questions about the efficiency increase of the interferonotherapy are still open (V. K. Kozlov et al., 2004). In this regard, the criteria of careful patients selection for enhancing the drugs effectiveness are necessary.

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Ask your gynecologist if he (she) has an experience in treatment of human papillomavirus infection to the complete removal of human papilloma virus from the body?

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