title: [Interferon-based versus direct antiviral therapy in patients with chronic hepatitis B].
abstract: Treatment of chronic hepatitis B is still challenging. Lots of parameters are needed to be considered before and during the therapy. There are several possible endpoints and their durability is very much variable. Patients with HBeAg-positive and HBeAg-negative hepatitis B need treatment. Two different strategies are available. Interferon-based therapy is a limited treatment, which might result in a sustained immune response in about one third of the patients, leading to an induced remission, sometimes years after the end of the treatment. According to the other strategy a continuous, indefinite oral nucleoside/nucleotide analogue (NA) treatment is administered to maintain a remission. However, relapse is rather frequent after the cessation of this therapy. During the long-term NA treatment drug resistance can lead to the loss of antiviral effect. Three first-line drugs are recommended, pegylated interferon alfa-2a, entecavir and tenofovir. If there is no contraindication to interferon, it is worth trying to achieve immune control and an induced remission. In patients, who do not respond to interferon, a sequential NA therapy is indicated.
authors.affiliation: Debreceni Egyetem, Orvos- és Egészségtudományi Centrum Belgyógyászati Intézet, Gasztroenterológiai Tanszék Debrecen Nagyerdei krt. 98. 4032. itornai@med.unideb.hu
authors.forename: István
authors.initials: I
authors.lastname: Tornai
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000998:Antiviral Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D004279:DNA, Viral / Q000187:drug effects; D004359:Drug Therapy, Combination; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000187:drug effects* / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D019259:Lamivudine / Q000627:therapeutic use; D009705:Nucleosides / Q000494:pharmacology / Q000627:therapeutic use*; D009711:Nucleotides / Q000494:pharmacology / Q000627:therapeutic use*; D063065:Organophosphonates / Q000627:therapeutic use; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D011744:Pyrimidinones / Q000627:therapeutic use; D011994:Recombinant Proteins; D000077712:Telbivudine; D000068698:Tenofovir; D013936:Thymidine / Q000031:analogs & derivatives; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D009705:Nucleosides; D009711:Nucleotides; D063065:Organophosphonates; D011744:Pyrimidinones; D011994:Recombinant Proteins; D000077712:Telbivudine; D019259:Lamivudine; D011092:Polyethylene Glycols; C413685:entecavir; D006147:Guanine; D000068698:Tenofovir; D000225:Adenine; C100416:peginterferon alfa-2a; C106812:adefovir dipivoxil; D013936:Thymidine