For the 350 million people chronically infected with HBV, the two therapeutic approaches currently available are immunomodulatory agents and antiviral chemotherapy. The first therapeutic agent was interferon-alpha (IFN-alpha), whose dual mode of action includes both antiviral and immunomodulatory effects. Unfortunately, extended IFN-alpha treatment is effective in no more than 15-25% of patients, and is associated with a wide spectrum of adverse reactions, although these limitations will be partially obviated by the likely approval of peginterferon-alpha for use in chronic HBV in the near future.
It is the nucleoside analogue named lamivudine that has become the gold standard worldwide for use in patients with chronic hepatitis B. Nevertheless, lamivudine-induced decreases in viral load are difficult to sustain over time due to occurrence of viral drug resistance. The drug resistance is associated with mutations in the very conserved catalytic polymerase /reverse transcriptase domain of the gene located at the YMDD motif.
The recent arrival of nucleotide analogue of HBV therapy is adefovir dipivoxil, whose antiviral efficacy was confirmed in large-scale clinical trials in both HBeAg-positive and HBeAg-negative chronic hepatitis B patients, achieving more than a 3-log decrease in viral load, drop in serum ALT levels, and improvement in liver histology after one to two years of treatment. Although virus resistant mutants did not seem to occur in adefovir-treated patients in 48 weeks and then up to 60 weeks of treatment, this did not turn out to be the case upon treatment after 96 weeks. The newly discovered mutant to adefovir (rtN236T) is located downstream from the YMDD motif in the D domain of the viral polymerase.
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Physicists have developed a new technique that uses electrical voltages to control the electron spin on a chip. The newly-developed method provides protection from spin decay, meaning that the contained information can be maintained and transmitted over comparatively large distances, as has been demonstrated by a team from the University of Basel’s Department of Physics and the Swiss Nanoscience Institute. The results have been published in Physical Review X.
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