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Adefovir and Entecavir: Which is better for hepatitis B?

2019-07-08 来源:亚科官网
Hepatitis B is a liver disease caused by hepatitis B virus (HBV). The virus interferes with liver function and causes pathological damage. A small number of infected people cannot eliminate the virus and become chronic infections, and thus face a high risk of dying from cirrhosis and liver cancer. The proportion of regular antiviral treatment in patients with chronic hepatitis B in China is only about 14%. There are many drugs for hepatitis B virus infection, including adefovir tablets and entecavir tablets, although the roles of the two are similar, There is also a big difference.
Adefovir dipivoxil tablets are acyclic adenine nucleoside derivatives, a diester precursor compound of adefovir, which acts by hydrolysis to adefovir in vivo. Adefovir is converted to a bisphosphonate with antiviral activity by intracellular phosphorylation, then competes with dioxyadenosine triphosphate, inhibits HBV DNA polymerase (reverse transcriptase) and absorbs and infiltrates into viral DNA, aborting Prolongation of DNA, thereby inhibiting HBV replication. Adefovir is active against HIV, hepatitis B virus, herpes simplex virus, cytomegalovirus, Epstein-Barr virus, etc. It is mainly used for the treatment of hepatitis B virus infection. It has low bioavailability and low protein binding rate. It is rarely metabolized in the liver, and is mainly excreted by the kidney in the original form. There may be adverse reactions such as abnormalities in the central nervous system, respiratory system, and liver AST, ALT, gastrointestinal discomfort, nausea, vomiting, and diarrhea.
And entecavir is a guanine nucleotide derivative, which is phosphorylated in vivo and converted into an active triphosphate, which inhibits the activity of hepatitis B virus polymerase by competing with deoxyguanosine triphosphate, including HBV-DNA polymerase. The initiation, the formation of the reverse transcriptional negative strand of the pre-gene messenger RNA, and the synthesis of the HBV-DNA positive strand, thereby inhibiting HBV replication. Entecavir is indicated for the treatment of chronic hepatitis B virus infections with active viral replication, elevated ALT, or liver histology showing active disease. The bioavailability of entecavir is as high as 100%. The food will reduce its absorption, adapt to fasting, wide distribution, low plasma protein binding rate, no effect on cytochrome P450, and excretion in the original form by the kidney. There may be central nervous system, Abnormal reactions of the endocrine system digestive system, skeletal system, AST, ALT elevation, and abnormalities such as rubella and blood system.
Related links: Entecavir