Antivirals for hepatitis B and C: Nursing pharmacology

Viral hepatitis is the inflammation of the liver caused by hepatitis viruses A, B, C, D, or E. Out of these, chronic hepatitis caused by hepatitis B virus, or HBV, and hepatitis C virus, or HCV, can be treated with antiviral medications.

Now, chronic HBV infection can be treated with a class of antiviral medications called NRTIs, which include nucleotide reverse transcriptase inhibitors like adefovir and tenofovir, as well as nucleoside reverse transcriptase inhibitors like entecavir; these medications are administered orally.

On the other hand, chronic HCV infection can be treated with antiviral medications that target different components of the virus, so they’re typically used in combination; these include nucleotide polymerase inhibitors like sofosbuvir, as well as nucleoside analogues like ribavirin, both of which are taken orally.

Finally, there’s a third class of medications that can be used to treat both chronic HBV and HCV; these include interferons like peginterferon alfa-2a, which is administered by subcutaneous injection.

Now, once administered, all of these antivirals have a different mechanism of action. NRTIs used to treat hepatitis B act by inserting into the replicating viral DNA. As a result, viral DNA synthesis is halted, ultimately stopping viral replication. On the other hand, medications used to treat hepatitis C work in different ways, inhibiting different viral proteins or enzymes required for viral replication. Interferons, on the other hand, induce the innate antiviral immune response that helps kill off cells that are infected by the virus.