title: Hepatitis B: encouraging the use of interferon.
abstract: OBJECTIVE
  Hepatitis B is a major cause of hepatocellular carcinoma and liver cirrhosis. Interferon (IFN)-based therapies provide the highest likelihood of achieving off-treatment virological and serological control although their use is often avoided because of the side-effect profile. We review recent developments regarding the use of IFN in the treatment of chronic hepatitis B, including proposed strategies to enhance efficacy while limiting treatment exposure for patients who are unlikely to achieve acceptable treatment endpoints.
  
  
  RESULTS
  The utility of host genetics (human leukocyte antigen associations and interleukin 28B) is yet to be defined. In hepatitis B e antigen (HBeAg)-positive disease, add-on IFN therapy to patients on entecavir may allow curtailment of nucleos(t)ide analogue treatment. In HBeAg-negative disease, an on-treatment stopping rule that measures decline of hepatitis B surface antigen and hepatitis B virus DNA at 12 and 24 weeks may identify up to two-thirds of poor responders. Prolonging IFN therapy to 96 weeks in patients with HBeAg-negative disease may improve virological and serological response rates. The combination of telbivudine and IFN therapy is contraindicated because of high rates of peripheral neuropathy.
  
  
  CONCLUSIONS
  These findings need to be confirmed in larger trials before they can be instituted into routine clinical practice.
authors.affiliation: aLiver and Hepatobiliary Unit bNIHR Liver Biomedical Research Unit, Queen Elizabeth Hospital, Birmingham, UK.
authors.forename: Thinesh Lee
authors.initials: TL
authors.lastname: Krishnamoorthy
authors.forename: David
authors.initials: D
authors.lastname: Mutimer
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000517:prevention & control*; D000075202:Contraindications; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006513:Hepatitis B e Antigens / Q000097:blood / Q000187:drug effects*; D006515:Hepatitis B virus / Q000187:drug effects*; D019694:Hepatitis B, Chronic / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000517:prevention & control*; D008113:Liver Neoplasms / Q000517:prevention & control*; D000077712:Telbivudine; D013936:Thymidine / Q000031:analogs & derivatives
chemical_list: D000276:Adjuvants, Immunologic; D000998:Antiviral Agents; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha; D000077712:Telbivudine; C413685:entecavir; D006147:Guanine; D013936:Thymidine