Adefovir is an antiviral medication belonging to the class of nucleotide analogues, specifically nucleotide reverse transcriptase inhibitors. Originally developed for the treatment of HIV, adefovir has found primary use in the management of chronic hepatitis B virus (HBV) infection. It inhibits the reverse transcriptase enzyme, crucial for viral replication, thereby suppressing the replication of HBV. Adefovir dipivoxil, the prodrug of adefovir, is administered orally and undergoes conversion to adefovir in the body. It is indicated for the treatment of chronic hepatitis B in adults with evidence of active viral replication and either evidence of persistent elevations in serum alanine aminotransferase (ALT) or histologically active disease. While adefovir is generally well-tolerated, long-term use may be associated with renal toxicity. Regular monitoring of renal function is essential during treatment. Resistance to adefovir can develop, necessitating careful management and potential combination therapy with other antiviral agents.
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