Recent Advances in the Treatment of Chronic Hepatitis B
Resource
EXPERT OPINION ON PHARMACOTHERAPY v.12 n.13 pp.2025-2040
Journal
EXPERT OPINION ON PHARMACOTHERAPY
Journal Volume
v.12
Journal Issue
n.13
Pages
2025-2040
Date Issued
2011
Date
2011
Author(s)
LIN, CHIH-LIN
KAO, JIA-HORNG
Abstract
Introduction: At present, two strategies exist for the treatment of chronic hepatitis B (CHB): i) standard or pegylated interferon alpha (IFN) with mainly immune modulatory effects; and ii) nucleos(t)ide analogues ( NA) with direct antiviral effects. The optimal treatment for an individual patient remains controversial. Areas covered: The treatment efficacy and prediction of response to antiviral agents for chronic hepatitis B are reviewed and discussed. Expert opinion: The rates of hepatitis B e antigen (HBeAg) and hepatitis B surface antigen (HBsAg) loss or seroconversion are continuously increasing in CHB patients after stopping a finite course of IFN, whereas long-term NA therapy is usually required to improve the adverse outcomes of CHB. Lower baseline HBV DNA level is a strong predictor for both sustained viral suppression and HBeAg seroconversion in patients receiving IFN-based as well as NAs therapy. In addition, HBeAg- positive patients with genotype A or B infection have better responses to IFN-based therapy than those with genotypes C or D infection. Furthermore, on-treatment predictors such as declines of serum HBV DNA, HBsAg and HBeAg levels may be helpful in making decisions of subsequent therapy. Regarding the association of host genetic factors with responses to antiviral therapy, current evidence is limited.
Subjects
antiviral therapy
chronic hepatitis B
drug-resistant hepatitis B virus
nucleos(t)ide analogues
pegylated interferon
SDGs