Antiviral therapy for chronic hepatitis B: are we doing any good to patients?
At the recent National Institutes of Health Consensus Development Conference, the value of antiviral therapy for chronic hepatitis B in improving clinical outcome was hotly debated. In patients with chronic hepatitis B, antiviral therapy has proved effective in viral load reduction, alanine aminotransferase normalization and histological improvements. However, its efficacy in reducing decompensated liver disease, hepatocellular carcinoma and liver-related death remains unclear. To date, animal studies and observational studies, but very few randomized controlled trials, have shown improved clinical outcomes after antiviral therapy. The difficulties of conducting clinical trials using clinical endpoints are highlighted. Before more clinical outcome data are available, it is important to validate the clinical implications of surrogate markers including biochemical, virological and histological responses.
Wong
Vincent Wai-Sun
VW
Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong.
Sung
Joseph Jao-Yiu
JJ
D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000517:prevention & control; D015975:Consensus Development Conferences, NIH as Topic; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014481:United States; D019562:Viral Load
D000998:Antiviral Agents; D000410:Alanine Transaminase