Treatment of chronic hepatitis B virus infection: an Asia-Pacific perspective.
Chronic hepatitis B infection is a serious health threat in the Asia-Pacific area. A consensus meeting on the treatment of chronic hepatitis B infection was conducted in Hong Kong, in August 1997. It was generally agreed that treatment of chronic hepatitis B infection should be based on the understanding of the natural history of chronic hepatitis B infection. To date, interferon alpha is the only Food and Drug Administration (FDA)-approved form of therapy for chronic hepatitis B infection. The overall response in Asian patients is unsatisfactory: approximately 15-20% will clear hepatitis B e antigen, but less than 5% will clear hepatitis B surface antigen. Newer immunomodulatory therapies are under trial. In contrast, nucleoside analogues, such as lamivudine (pending FDA approval) and famciclovir, have been shown to be potent suppressors of hepatitis B viral replication; however, their role as monotherapy in the treatment of chronic hepatitis B infection remains to be defined. Also, the issues of resistance to nucleoside analogues and withdrawal rebound need to be carefully studied. The future direction of therapy in chronic hepatitis B infection is probably a combination of nucleoside analogues or nucleoside analogues with immunomodulatory therapy.
Department of Medicine, Queen Mary Hospital, Hong Kong, China. GKKLau@hkstar.com
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D015075:2-Aminopurine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use; D001208:Asia; D004359:Drug Therapy, Combination; D000077595:Famciclovir; D017325:Hepatitis B Vaccines / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000187:drug effects / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000628:therapy*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D010139:Pacific Islands; D019444:Vaccines, DNA / Q000627:therapeutic use
D000276:Adjuvants, Immunologic; D000998:Antiviral Agents; D017325:Hepatitis B Vaccines; D019444:Vaccines, DNA; D019259:Lamivudine; D015075:2-Aminopurine; D000077595:Famciclovir