J Korean Med Sci.  2004 Aug;19(4):489-494. 10.3346/jkms.2004.19.4.489.

Current Antiviral Therapy for Chronic Hepatitis B

Affiliations
  • 1Department of Internal Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea. djsuh@amc.seoul.kr

Abstract

During the past decade, major breakthroughs have been achieved in treatment of chronic hepatitis B. Currently, three therapeutic agents are approved for chronic hepatitis B: interferon-alpha, lamivudine and adefovir dipivoxil. In patients with HBeAgpositive chronic hepatitis B, all of these drugs achieve HBeAg loss (24-33%) and anti-HBe seroconversion (12-30%) rates that are superior to those observed in untreated controls. Interferon-alpha has several drawbacks, such as the parenteral administration and the development of frequent and potentially serious side effects. Lamivudine is a safe drug with rare and generally mild side effects. Lamivudine induces an initial virological remission in 70-90% of patients, but only 30-40% of patients remain in remission after the third year due to progressively increasing viral resistance. The main advantage of adefovir dipivoxil is the rare emergence of resistance, which has been identified in less than 2% of patients at 2 yr of treatment. Adefovir is also effective against lamivudine-resistant strains. This review will focus on the natural history and recently gained knowledge on the treatment of chronic hepatitis B.

Keyword

Hepatitis B; Hepatitis B Virus; Interferon-alpha; Lamivudine; Adefovir Dipivoxil; Antiviral Agents

MeSH Terms

Adenine/*analogs & derivatives/therapeutic use
Antiviral Agents/*therapeutic use
Hepatitis B/*drug therapy
Humans
Interferon-alpha/therapeutic use
Lamivudine/therapeutic use
Phosphonic Acids/therapeutic use
Reverse Transcriptase Inhibitors/therapeutic use
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