Avtor/Urednik		Brinovec, Vladimir; Lešničar, Gorazd
Naslov		Sodobno zdravljenje kroničnega hepatitisa B
Prevedeni naslov		Modern therapy for chronic hepatitis B
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 41, št. Suppl 2
Leto izdaje		2002
Obseg		str. 113-22
Jezik		slo
Abstrakt		For over a decade, patients with chronic hepatitis B in Slovenia have been treated with inteferon alpha. Until 1988, such patients had been treated symptomatically only, with corticosteroids being given only in individual cases. Recently, treatment with lamivudine as well as famcyclovir, adenovir and other nucleoside analogues is becoming widely accepted. Despite the appearance of resistance to nucleoside analogues (YMDD mutants), lamivudine in particular has also been successfully used in the treatment of patients with decompensated hepatitis B related liver cirrhosis. In combination with specific immunoglobulins against hepatitis B, lamivudine is also used in patients with chronic hepatitis B and patients with liver transplants, and in chronic hepatitis B patients who have concurrent hepatitis C and/or D or HIV infection. Lamivudin has also been proven effective in the treatment of chronic hepatitis B in children, and in patients with extrahepatic symptoms of hepatitis B infection (polyarteritis nodosa, glomerulonephritis) and in hepatitis B patients receiving chemotherapy; it is also used for the prevention of perinatal and nosocomial infections in highly viremic health workers. In the future, combined treatment with nucleoside analogues and pegylated interferons is expected to prove most promising.
Izvleček		Bolnike s kroničnim hepatitisom B v Sloveniji že več kot deset let zdravimo z interferonom alfa. Do leta 1988 smo v Sloveniji zdravili le simptomatsko, v posameznih primerih tudi s kortikosteroidi. V zadnjem času se za zdravljenje vse bolj uveljavljajo lamivudin, pa tudi famciklovir, adenovir in drugi nukleozidni analogi. Kljub pojavu odpornosti na nukleozidne analoge (YMDD-mutacije), zlasti lamivudin uspešno uporabljajo tudi pri zdravljenju bolnikov z dekompenzirano jetrno cirozo zaradi hepatitisa B. V kombinaciji s specifičnimi imunoglobulini proti hepatitisu B uporabljajo lamivudin tudi za zdravljenje bolnikov s kroničnim hepatitisom B s presajenimi jetri, kroničnih bolnikov s hepatitisom B, sočasno okuženih z virusom hepatitisa C ali/in hepatitisom D ali s HIV. Lamivudin se je izkazal tudi pri zdravljenju kronično okuženih otrok z virusom hepatitisa B, bolnikov z znaki okužbe s hepatitisom B zunaj jeter (poliarteritis nodosa, glumerulonefritis), kroničnih bolnikov s hepatitisom B, ki so na kemoterapiji ter pri preprečevanju obporodne in tudi bolnišnične okužbe pri visoko viremičnih zdravstvenih delavcih. V prihodnosti dosti obeta kombinirano zdravljenje z nukleozidnimi analogi in pegiliranim interferonom.
Deskriptorji		HEPATITIS B INTERFERON TYPE I NUCLEOSIDES ANTIVIRAL AGENTS