Current Treatment of Chronic Hepatitis B

Seven drugs have been approved for treatment of chronic hepatitis B (CHB), including two immune modulators. interferon alfa-2b and peginterferon (PegIFN) alfa-2a, and five antivirals, lamivudine, adefovir, entecavir, telbivudine and tenofovir The preferred treatment is entecavir, tenofovir, or PegIFN based Cl their high potency and low rate of resistance. Therapy should be initiated when hepatitis B virus (HBV) DNA levels are >= 20,000 IU/mL in hepatitis B e antigen (HBeAg)-positive CHB or >= 2,000 IU/mL in HBeAg-negative CHB, along with elevated alanine aminotransferase (ALT) levels Or active disease On liver biopsy Therapy with PegIFN is finite over one year, while oral antiviral therapy for HBeAg-positive CHB is continued until HBeAg seroconversion and treatment of HBeAg-negative CHB is long-term. If oral therapy is inadequate or results in drag resistance. therapy should be changed by two ching to an alternative drug OF adding a second chug. The ultimate goal of therapy is loss of hepatitis B surface antigen (HBsAg) and a reduced rate of progression to cirrhosis and/or hepatocellular carcinoma (HCC).