Hepatitis B Treatment (Cont.)

Medications Used for Chronic Hepatitis B Treatment

The U.S. Food and Drug Administration (FDA) has approved six drugs for the treatment of chronic hepatitis B. These hepatitis B medications are:
 
  • Alpha interferon
  • Pegylated alpha interferon
  • Lamivudine (Epivir-HBV®)
  • Adeforvir dipivoxil (Hepsera®)
  • Entecavir (Baraclude®)
  • Telbivudine (Tyzeka®).
     
These medicines differ in a number of respects. While some of these medicines are given by injection, others are taken by mouth. Some other differences include:
 
  • How long they are taken
  • How effective they are in clearing the hepatitis B virus and stopping any liver damage
  • Whether they are approved for use in children as well as adults
  • Side effects
  • Interactions with other medicines
  • Whether or not they increase the risk of a severe and sudden worsening of hepatitis B symptoms after stopping the medicine.
     
If you are taking any of these medicines, you should stop treatment with the medicine only after a careful discussion with your doctor. These drugs should not be used during pregnancy.
 

Chronic Hepatitis B Treatment Goals

The goals of chronic hepatitis B treatment are to:
 
  • Suppress the hepatitis B virus indefinitely
  • End any active liver disease.
     
Patients with HBeAg-positive chronic hepatitis who have a substantial decrease in the level of HBV DNA (the genetic material of the virus) and a loss of HBeAg at the end of therapy are said to have had a virologic response to treatment. A sustained virological response (SVR) is one that continues for 6 to 12 months after therapy ends. Patients who have a sustained loss of HBsAg are deemed to have a complete response to antiviral therapy, but this does not happen very often.
 
The response rate to alpha interferon or lamivudine is above 50 percent in patients whose ALT levels (an enzyme found in liver cells) are greater than 5 times the upper limit of normal. The response rate is lower (about 20 to 35 percent) in patients with ALT levels two to five times the upper limit of normal. In patients with ALT levels less than two times the upper limit of normal, response rates are poor and therapy should be deferred.
 
(Hepatitis B Treatment Continued: Page 3)

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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD