Pros and Cons of Peginterferon Versus Nucleos(t)ide Analogues for Treatment of Chronic Hepatitis B.
The emergence of new and more potent treatment options has markedly changed the treatment landscape of chronic hepatitis B. Both peginterferon and nucleos(t)ide analogues have considerable advantages and limitations, and current treatment guidelines refrain from clearly suggesting a first-line treatment option. Peginterferon offers the advantage of higher sustained response rates in both hepatitis B early antigen (HBeAg)-positive and HBeAg-negative patients, at the price of considerable side effects and high costs. Nucleos(t)ide analogues offer easy daily oral dosing, and newly registered agents can maintain viral suppression for prolonged treatment duration. However, relapse is common after therapy discontinuation and extended therapy therefore often necessary. Prolonged treatment with nucleos(t)ide analogues may enhance chances of virologic and serologic response at the potential cost of the emergence of viral resistance and side effects. Baseline and on-treatment prediction of response may help select patients for peginterferon therapy and can aid individualized treatment decisions concerning therapy continuation or discontinuation.
Sonneveld
Milan J
MJ
Janssen
Harry L A
HL
Antivir Ther. 2007;12(5):815-23
17713165
N Engl J Med. 2003 Feb 27;348(9):808-16
12606735
N Engl J Med. 2008 Oct 2;359(14):1486-500
18832247
N Engl J Med. 2008 Dec 4;359(23):2442-55
19052126
Lancet. 2009 Feb 14;373(9663):582-92
19217993
Hepatology. 2007 Feb;45(2):507-39
17256718
N Engl J Med. 2002 Jul 18;347(3):168-74
12124405
J Hepatol. 2000 Feb;32(2):300-6
10707871
N Engl J Med. 2006 Mar 9;354(10):1011-20
16525138
Hepatology. 2009 Apr;49(4):1151-7
19115222
N Engl J Med. 2007 Dec 20;357(25):2576-88
18094378
Hepatology. 2009 May;49(5 Suppl):S185-95
19399802
Hepatology. 2007 Aug;46(2):388-94
17604363
Gut. 2007 May;56(5):699-705
17127704
N Engl J Med. 2004 Sep 16;351(12):1206-17
15371578
Gastroenterology. 2007 Nov;133(5):1437-44
17983800
N Engl J Med. 2006 Mar 9;354(10):1001-10
16525137
J Viral Hepat. 2000 Sep;7(5):382-6
10971827
Am J Gastroenterol. 2007 Jan;102(1):96-104
17266689
N Engl J Med. 1999 Oct 21;341(17):1256-63
10528035
Aliment Pharmacol Ther. 2005 May 1;21(9):1163-71
15854180
Hepatology. 2004 Mar;39(3):804-10
14999700
Gastroenterology. 2008 Aug;135(2):459-67
18585385
Hepatology. 2003 Apr;37(4):748-55
12668966
N Engl J Med. 1996 May 30;334(22):1422-7
8618580
Hepatology. 2009 May;49(5 Suppl):S96-S102
19399800
Hepatology. 2006 Feb;43(2 Suppl 1):S182-93
16447260
Lancet. 2005 Jan 8-14;365(9454):123-9
15639293
J Hepatol. 2009 Feb;50(2):289-95
19070393
Ann Intern Med. 2009 Jan 20;150(2):104-10
19124811
Gastroenterology. 2009 Dec;137(6):2002-9
19737568
N Engl J Med. 2004 Oct 7;351(15):1521-31
15470215
Kidney Int. 2004 Sep;66(3):1153-8
15327411
Hepatology. 2001 Jun;33(6):1527-32
11391543
Gastroenterology. 2009 Jun;136(7):2169-2179.e1-4
19303414
J Hepatol. 2008;48 Suppl 1:S2-19
18304680
Gastroenterology. 2004 Jun;126(7):1750-8
15188170
J Hepatol. 2008 Feb;48(2):335-52
18096267
J Hepatol. 2009 Feb;50(2):227-42
19054588
N Engl J Med. 2005 Jun 30;352(26):2682-95
15987917
J Hepatol. 2002 Nov;37(5):669-74
12399235
Am J Gastroenterol. 2007 Dec;102(12):2718-23
17662102
Hepatology. 2008 Feb;47(2):428-34
18220290
Hepatology. 2009 Apr;49(4):1141-50
19338056
Hepatology. 2006 Sep;44(3):721-7
16941701
Hepatology. 2009 May;49(5 Suppl):S112-21
19399795
Antiviral Res. 2003 Oct;60(2):87-9
14638403
Gut. 2005 Nov;54(11):1604-9
15923670