Emerging treatments in chronic hepatitis B.
Although the management of chronic hepatitis B has improved over the last decade, none of the available therapeutic agents, IFN-alpha, lamivudine and adefovir dipivoxil, can achieve sustained off-therapy responses in most cases. Therefore, several newer, mainly antiviral and immunomodulatory agents, are being evaluated. Pegylated IFN-alpha(2a) has been shown to be more effective than lamivudine or standard IFN-alpha monotherapy in achieving post-therapy biochemical and virological responses, and is expected to be licensed soon for the treatment of chronic hepatitis B. Newer antiviral agents, such as entecavir and telbivudine, appear to be quite effective initially, but their sustained off-therapy response rates remain unknown. The preliminary data of monotherapies with immunomodulatory agents, or of combination therapies, have been rather disappointing. Long-term maintenance treatment with antiviral agent(s) with good safety and tolerability profiles and low resistance rates appears to be the most realistic future therapeutic option for most chronic hepatitis B patients.
Hadziyannis
Stephanos J
SJ
Henry Dunant Hospital, Department of Medicine and Hepatology, 107 Messogion Avenue, Athens 11526, Greece. hadziyannis@ath.forthnet.gr
Papatheodoridis
George V
GV
D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004338:Drug Combinations; D024882:Drug Resistance, Viral; D004358:Drug Therapy / Q000639:trends; D006515:Hepatitis B virus / Q000187:drug effects / Q000502:physiology; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D063065:Organophosphonates / Q000627:therapeutic use; D011994:Recombinant Proteins; D014612:Vaccines / Q000008:administration & dosage
D000998:Antiviral Agents; D004338:Drug Combinations; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D063065:Organophosphonates; D011994:Recombinant Proteins; D014612:Vaccines; D019259:Lamivudine; D000225:Adenine; C106812:adefovir dipivoxil