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Semin Liver Dis 2003; 23(1): 081-088
DOI: 10.1055/s-2003-37584
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Treatment of HBeAg-Negative Chronic Hepatitis B

Stephanos J. Hadziyannis1 , George V. Papatheodoridis2 , Dimitrios Vassilopoulos3
  • 1Professor, Department of Medicine and Hepatology, Henry Dunant Hospital, Athens, Greece
  • 22nd Academic Department of Medicine, Hippokration General Hospital, Athens, Greece
  • 3Department of Medicine and Hepatolog, Henry Dunant Hospital, Athens, Greece
Further Information

Publication History

Publication Date:
03 March 2003 (online)

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ABSTRACT

The goals of therapy in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) are to abolish or efficiently suppress viral replication, which represents the main determinant of underlying liver necroinflammation and fibrosis. Currently available agents include interferon-alfa (IFN-α), lamivudine, and soon adefovir dipivoxil. A ≥ 12-month course of IFN-α treatment or retreatment achieves sustained biochemical responses in 15 to 25% of patients with eventual hepatitis B surface antigen (HBsAg) loss and anti-HBs development in a proportion of them. Lamivudine induces initial virologic and biochemical responses in 70 to 90%, but breakthroughs due to lamivudine-resistant mutants accumulate with continuation of therapy and thus only one third of patients may remain in remission after the third year of therapy. Adefovir dipivoxil also achieves on-therapy responses in the majority of cases. Adefovir dipivoxil and entecavir appear to be effective against lamivudine-resistant strains. Many other antiviral agents and immunomodulatory approaches are currently evaluated for CHB, but, besides IFN-α, none has yet been convincingly shown to induce sustained off-therapy responses.

KEYWORDS

Chronic hepatitis B - antiviral therapy - interferon-alfa (IFN-α) - nucleoside analogues - viral resistance

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