Background Chronic infection by Hepatitis B virus (HBV) affects more than 350 million people worldwide. Recently, there have been significant advances in the understanding of this disease, a new diagnostic tool that can accurately determine the activity of HBV replication, the identification of mutations involving resistance to antiviral drugs and clinical studies that have evaluated the efficacy and safety of new drugs against HBV. All these developments have led to changes in treatment recommendations of international clinical guidelines such as the American Association for the Study of Liver Diseases (AASLD) and the European Association for the Study of the Liver (EASL).
Purpose To describe how the prescription of antiviral drugs against HBV has changed in an outpatient dispensing service in a community hospital.
Materials and methods Retrospective observational study of antivirals dispensed against HBV in not co-infected patients in an outpatients department over the last six years.
Results The number of patients increased from 32 patients in 2006 to 59 in 2011. The percentage of patients treated with antiviral drugs in this period was as follows (see table).
Data show an increase in the percentage of patients treated with entecavir and tenofovir, and a decrease in lamivudine and adefovir. The approval of entecavir and tenofovir in 2006 and 2008 respectively, and new recommendations in clinical guidelines, are the reason for this change. Both AASLD and EASL recommend avoiding lamivudine, telbivudine and adefovir as first line treatment in treatment-naive patients since they have a low genetic barrier, and avoiding adefovir because it is a weak antiviral.
Conclusions The prescription of antiviral drugs against HBV in our hospital has changed during recent years in response to new recommendations and clinical guidelines. Further changes in HBV treatment are expected, so more prospective studies are needed to ensure safe and effective pharmacotherapy.
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