Therapy for hepatitis B. Current situation and perspectives

Many advances have been made over the past decade in the treatment of chronic hepatitis B; in particular, the availability of new drugs has opened better strategies for the control of viral replication. There are at least four licensed therapies for HBV infection: the immunomodulators interferon-alpha and peginterferon-alpha 2a as well as the nucleos(t)ide analogues lamivudine and Adefovir Dipivoxil while the nucleoside-analogues entecavir and telbivudine will be approved in the near future. To control HBV-infection, long-term treatment for several years is needed for most of the patients. In only a small proportion of the patients can sustained remission be achieved after a short-term treatment of 6-12 months. Unfortunately, long-term treatment with the nucleos(t)ide is associated with a major risk of developing drug resistance. Strategies to achieve sustained responses and concepts to prevent progression to cirrhosis, as well as drug resistance, will be outlined in this communication.