A review of oral antiretroviral therapy for the treatment of chronic hepatitis B.
OBJECTIVE
To describe the current evidence for the use of oral antiretroviral (ARV) agents in the treatment of chronic hepatitis B (CHB).


METHODS
A search from 1950 to April 2010 was conducted using the databases PubMed and MEDLINE with the search terms chronic hepatitis B, lamivudine, entecavir, adefovir, telbivudine, tenofovir, emtricitabine, clevudine, and pradefovir. The search was limited to trials conducted in humans that were published in the English language.


METHODS
Studies were included if they evaluated the use of oral ARVs in patients with CHB infection who were not coinfected with hepatitis C, hepatitis D, or HIV.


RESULTS
Oral ARVs have revolutionized the treatment of CHB. Studies conducted comparing ARVs have favored entecavir and tenofovir with respect to their ability to decrease hepatitis B virus DNA viral load while minimizing the development of resistance. However, low seroconversion rates, recurrent viremia when ARV therapy is discontinued, and increased resistance rates with longer treatment durations limit the benefit of oral ARVs in the treatment of CHB. Combination therapy has been a suggested solution; however, studies have yet to prove additional benefit over currently recommended monotherapy.


CONCLUSIONS
Oral ARVs should continue to be used in the treatment of CHB; however, research is needed to define the optimal duration of therapy, evaluate the utility of combination therapy, and explore novel targets within the hepatitis B life cycle.
Hynicka
Lauren M
LM
School of Pharmacy, University of Maryland, Baltimore, MD 21201, USA. lhynicka@rx.umaryland.edu
Yunker
Nancy
N
Patel
Punam H
PH
D000284:Administration, Oral; D044966:Anti-Retroviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004279:DNA, Viral / Q000187:drug effects; D024882:Drug Resistance, Viral; D004359:Drug Therapy, Combination; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D019562:Viral Load / Q000187:drug effects
D044966:Anti-Retroviral Agents; D004279:DNA, Viral