Adefovir dipivoxil

In chronic hepatitis B therapy there are new and exciting developments in antivirals such as nucleotide analogues. Adefovir is the latest drug approved for therapy of chronic hepatitis B. This agent has a potent in vitro and in vivo effect against herpes virus, retroviruses and hepadnaviruses. In the hepatitis B virus setting, adefovir dipivoxil inhibits both the wild type and HBV lamivudine-resistant strains. Adefovir is an oral drug and the recommended dose for chronic hepatitis B is 10 mg daily. The safety profile of this dose is excellent but higher doses can produce renal tubular damage, particularly when the drug is used for prolonged therapy. Up to now, no evidence of HBV resistance to adefovir dipivoxil has been detected, and this constitutes one of its main advantages as it permits longer duration of therapy. Adefovir is an important new addition to current first-line treatments for HBeAg and anti-HBe-positive chronic hepatitis B, as well as being rescue therapy for lamivudine-resistant HBV strains.