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Indexed/Abstracted in: CAB, EMBASE, PubMed/MEDLINE, Scopus, Emerging Sources Citation Index
Online ISSN 1827-1642
AN UPDATE ON HEPATITIS B VIRUS INFECTION
Marcellin P., Boyer N., Asselah T.
Division of Hepatology and INSERM CRB3 University of Paris VII, Beaujon Hospital
Five agents are currently approved for the treatment of chronic hepatitis B: standard interferon-a (IFN-a), pegylated interferon-a 2a (PEG-IFN-a 2a), lamivudine, adefovir and entecavir. Each agent has inherent limitations. IFN and PEG-IFN-a 2a are effective in a minority of patients and have frequent side effects that limit their tolerability. The efficacy of lamivudine is limited by the emergence of drug-resistant hepatitis B virus (HBV) mutants, restricting its utility as a long-term therapy. Adefovir is well tolerated and associated with a low incidence of resistance but its antiviral effect is not optimal. Entecavir, which has been recently registered, has a more potent anti-viral effect but its long term efficacy and resistance profile is still not known. These antivirals induce a sustained response after withdrawal of therapy in only a minority of patients and therefore the treatment needs to be indefinitely administered in the majority of patients. After a brief summary of the natural history of chronic hepatitis B in order to understand the indications and the objectives of therapy, this review focuses on treatment of HBeAg-negative chronic hepatitis B with IFN and PEG-IFN-a 2a.