Pegylated interferons in chronic HBV: Alone or as combination therapy

Pegylated interferons have been investigated recently in the treatment of chronic hepatitis B in both hepatitis B e antigen (HBeAg)-positive, as well as HBeAg-negative, Asian and white patients. Pegylated interferon alfa-2a monotherapy has been compared in randomized studies with standard interferon, lamivudine, and with a combination of pegylated interferon and lamivudine. The results indicate the superiority of pegylated interferon alfa-2a over standard interferon and lamivudine and failure of combination therapy to further enhance antiviral efficacy. A trial with pegylated interferon alfa-2b in HBeAg-negative disease showed no benefit of combination therapy compared with pegylated interferon monotherapy, but there was no lamivudine monotherapy arm in the study. Pending final trial results and regulatory approval, pegylated interferons are likely to be recommended as the first-line therapy for chronic hepatitis B.