Current and future treatment of chronic hepatitis B

L. R. Arosemena, R. A. Cortes, L. Servin, E. R. Schiff

Research output: Contribution to journalReview article

3 Scopus citations

Abstract

Hepatitis B virus (HBV) infection is an ongoing worldwide pandemic. In general, the mode of transmission is different according to its prevalence in different areas: mostly perinatal in highly prevalent zones and predominantly sexual and/or parenteral in low prevalance areas. The variation in presentations of chronic hepatitis B (CHB) make its management complex. Aminotransferase levels, viral load, histologic changes, age of the patient, viral mutations (e.g. hepatitis B e antigen negative) and pregnancy are all factors that impact on treatment decisions. The ideal drug that will eradicate the HBV has yet to be developed. This review focuses on the currently available medications for CHB: α-interferon, lamivudine, adefovir, as well as new drugs that have proven to be active against HBV in clinical trials and are closer to licensure; pegylated interferon tenofovir, entecavir, emtricitabine, telbivudine and clevudine. The antiviral properties and the advantages and disadvantages in HBeAg-positive and negative patients are discussed. Combinations of different medications currently under study were not included in this review. A suggested algorithm, developed from recent literature, may serve as a practical guide on tailoring drug selection based on viral load, aminotransferases, hepatitis B e antigen status and histological findings. Finally, practical management questions are raised.

Original languageEnglish (US)
Pages (from-to)77-93
Number of pages17
JournalMinerva Gastroenterologica e Dietologica
Volume51
Issue number1
StatePublished - Dec 1 2005

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Keywords

  • Hepatitis B, diagnosis
  • Hepatitis B, therapy
  • Treatment, outcome

ASJC Scopus subject areas

  • Gastroenterology

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