Recent Advances in the Management of Chronic Hepatitis B

There are seven approved treatments for adults with chronic hepatitis B virus infection in the United States and European countries: interferon-α, pegylated interferon-α, lamivudine, adefovir dipivoxil, entecavir, telbivudine, and tenofovir disoproxil fumarate. At present, two new analogues, entecavir and tenofovir are recommended as the first line therapy by the guidelines of European Association for the Study of the Liver and American Association Study for the Liver Diseases. On the other hand, regarding interferon therapy, use of pegylated interferon-α is recommended as the first line therapy instead of standard interferon-α by both guidelines. Therefore, the main scientific interests and unmet medical needs for treatment of chronic hepatitis B have been narrowed down to long-term efficacy and safety of the two said analogues-entecavir and tenofovir-and combination therapy of pegylated interferon-α with the two analogues. To put it concretely, further studies are needed to assess (1) the long-term efficacy and safety and resistance to entecavir and tenofovir; (2) the efficacy of different durations (24 weeks to 2 years) and lower doses of pegylated interferon-α; (3) the role of combination therapy with two analogues to reduce resistance; and (4) the efficacy and safety of the two analogues with decompensated cirrhosis. Herein, we review the recent available data and results.

Keywords: Hepatitis B virus; Interferon alpha; Nucleotide analogues; Entecavir; Tenofovir

• Implication for health policy/practice/research/medical education:
  Several therapeutic modalities exist for the treatment of chronic hepatitis B. Based on recent available data, this review endeavors to present the long-term efficacy and safety of these modalities especially for entecavir and tenofovir as well as pegylated interferon-α.
• Please cite this paper as:
  Kim SR, Yang J, Kudo M, Hino O. Recent Advances in the Management of Chronic Hepatitis B. Hepat Mon. 2011;11(8):601-11. [DOI: 10.5812/kowsar.1735143X.657]

©  2011 Kowsar M.P.Co. All rights reserved.