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Los virus de las hepatitis B (VHB) y C (VHC) son responsables de una elevada morbimortalidad de distribución mundial. Las consecuencias clínicas de las infecciones por estos virus (hepatitis crónica, cirrosis, hepatocarcinoma) van a depender de factores relacionados con el huésped y con el agente viral. Entre estos últimos, cada vez cobran más importancia aquellos que se relacionan con la respuesta al tratamiento antiviral, como son la aparición de mutantes de resistencia y la infección asociada a genotipos específicos del virus. En el caso del VHB, al igual que lo establecido para el virus de la inmunodeficiencia humana (VIH), es de vital importancia la presencia y acumulación de mutaciones responsables de la resistencia a los antivirales aprobados para el tratamiento de la infección, o de otros de reciente aplicación. Se han desarrollado técnicas para la detección de dichas mutaciones, así como algoritmos para predecir la respuesta al tratamiento. En los pacientes infectados por el VHC, sin embargo, la respuesta al tratamiento se encuentra más relacionada con la infección por genotípicos específicos, aunque en los últimos años se ha ampliado notablemente el conocimiento sobre los mecanismos moleculares de la respuesta al interferón en dichos pacientes.
Palabras clave:
VHB y VHC
Resistencias
Antivirales
Infection by the hepatitis B (HBV) and C (HCV) viruses is a major cause of morbidity and mortality world-wide. The clinical outcomes of infection by these viruses (e.g., chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma) depend on several factors related to the host and the viral agent. Among the latter, factors associated with the response to current antiviral therapies, such as he emergence of resistance mutants and the genotype responsible for the infection, are gaining increasing importance. As has been established for human immunodeficiency virus (HIV), the presence of resistance mutations in the viral polymerase constitutes the main problem for treating HBV infection with approved drugs and those recently applied. Methods have been developed to detect these mutations, as well as algorithms to predict the response to treatment. The outcome of treatment for HCV infection is highly influenced by the viral genotype, however, and our inderstanding of the molecular basis for the response to interferon in these patients has grown considerably in recent years.
Key words:
HBV and HCV
Resistance
Antiviral drugs
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