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2019, Número 1

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Biotecnol Apl 2019; 36 (1)


Terapias contra la hepatitis B crónica: desafíos y oportunidades

Aguila-Rubido JC, van de Klundert MAA, Michel ML

Idioma: Ingles.
Referencias bibliográficas: 57
Paginas: 1401-1410
Archivo PDF: 399.36 Kb.


RESUMEN

La hepatitis B crónica (HBC) es un problema de salud global, a pesar de los avances en su prevención y tratamiento. Los casos de carcinoma hepotocelular y cirrosis hepática causados por la progresión de la enfermedad abarcan más de la mitad de todos los fallecimientos. La Organización Mundial de la Salud (OMS) inició una campaña para el control de la mortalidad producto de las hepatitis virales. La ausencia de un efecto antiviral sostenido después del cese del tratamiento y su impacto en la seroconversión a los antígenos de superficie (HBsAg) y e (HBeAg) del virus de la hepatitis B (HBV), se mantienen como limitaciones de las terapias aprobadas, a pesar de la alta eficacia de los tratamientos actuales para el control de la replicación del HBV. Además, la implementación de terapias de larga duración con análogos de nucleós(t)idos (NUC) incrementa los costos del tratamiento y limita su eficacia epidemiológica. La comprensión reciente de la inmunología y la fisiología de la HBC ha permitido el desarrollo de varias terapias innovadoras. Su implementación requerirá que se alcancen los objetivos trazados por la OMS en términos de morbilidad y mortalidad durante la próxima década. En este artículo se revisan las principales terapias aprobadas para el tratamiento de la HBC, junto a los trabajos presentados en los congresos más recientes de las principales sociedades para el estudio del hígado, así como los desarrollos preclínicos y clínicos de terapias innovadoras. Además, se discuten las estrategias vacunales terapéuticas contra la HBC en desarrollo y algunos de sus desafíos y oportunidades.


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