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 include:
- 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 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 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 only after a careful discussion with your doctor. These drugs should not be used during pregnancy.
Treatment Goals for Chronic Hepatitis B
The goals of chronic hepatitis B treatment are to:
- Suppress the virus indefinitely
- End any active liver disease.
People 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. People who have a sustained loss of HBsAg are deemed to have a complete response to antiviral therapy, but this does not happen often.
The response rate to alpha interferon or lamivudine is above 50 percent in people whose ALT levels (an enzyme found in liver cells) are greater than five times the upper limit of normal. The response rate is lower (about 20 to 35 percent) in people with ALT levels two to five times the upper limit of normal. In people with ALT levels less than two times the upper limit of normal, response rates are poor and therapy should be deferred.
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