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entecavir + 18alpha-glycyrrhizin is a combination therapy investigated for the treatment of chronic hepatitis B and liver cirrhosis. Entecavir is a potent nucleoside analog that functions as an inhibitor of the Hepatitis B virus (HBV) DNA polymerase, effectively blocking viral replication by competing with the natural substrate deoxyguanosine triphosphate. 18alpha-glycyrrhizin, a stereoisomer of the triterpenoid saponin glycyrrhizin, acts as a hepatoprotective and anti-inflammatory agent. Its primary mechanism involves the inhibition of High Mobility Group Box 1 (HMGB1), a pro-inflammatory cytokine-like molecule released during liver injury. By combining these two agents, the therapy aims to achieve both profound viral suppression and a reduction in hepatic inflammation and fibrogenesis. This combination has been notably studied by the Shanghai Public Health Clinical Center to improve clinical outcomes and liver function in patients with advanced HBV-related liver disease.
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