The practising clinician is currently faced with a number of effective treatment options for chronic hepatitis B, including two formulations of interferon (standard IFN and pegylated IFN) and five nucleos(t)ide analogues (lamivudine, adefovir, entecavir, telbivudine and tenofovir). Treatment strategies can be divided into those aiming for sustained response after discontinuation of therapy and those that need to be maintained by prolonged antiviral therapy. Sustained response is particularly achieved with interferon-based therapy, while treatment-maintained response can be achieved with long-term nucleos(t)ide analogue therapy in the majority of patients. Of currently available drugs for the treatment of chronic hepatitis B, PEG-IFN seems to result in the highest rate of off-treatment sustained response after a 1-year course of therapy. Sustained transition to the immune-control phase (inactive HBsAg carrier state) can be achieved in 30-35% of HBeAg-positive patients and 20-25% of HBeAg-negative patients. Loss of HBsAg has been observed in 11% of both HBeAg-positive and HBeAg-negative patients after 3-4 years. Since hepatitis B virus (HBV) genotype is an important predictor of response to PEG-IFN, determination of HBV genotype is essential in patients in whom sustained off-treatment response is pursued. Aiming for sustained response is of particular interest because many HBV-infected patients are in need of antiviral therapy at a young age and may otherwise require indefinite antiviral therapy.

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Keywords Hepatitis B virus, Sjoegren syndrome, adefovir, agitation, alopecia, alpha interferon, anorexia, antibody production, article, autoimmune disease, cardiotoxicity, clinical trial, combination chemotherapy, cytopenia, depression, diabetes mellitus, diarrhea, drug contraindication, drug half life, drug induced headache, drug metabolism, drug response, drug tolerability, entecavir, fatigue, fever, flu like syndrome, genotype, hearing loss, hepatitis B, hepatitis B surface antigen, hepatitis B(e) antigen, human, immune response, induced hypothermia, injection site erythema, insomnia, interferon, irritability, lamivudine, libido disorder, long term care, mental instability, monotherapy, myalgia, neutropenia, nonhuman, nucleoside derivative, optic neuritis, peginterferon, peginterferon alpha2a, peginterferon alpha2b, pegylated interferon, polyneuropathy, practice guideline, retinopathy, seizure, seroconversion, side effect, suicidal ideation, sustained response, taste disorder, telbivudine, tenofovir, thrombocytopenia, thyroiditis, treatment duration, virus gene
Persistent URL dx.doi.org/10.1016/j.bpg.2008.11.007, hdl.handle.net/1765/15851
Journal Best Practice and Research in Clinical Gastroenterology
Citation
Buster, E.H.C.J, Schalm, S.W, & Janssen, H.L.A. (2008). Peginterferon for the treatment of chronic hepatitis B in the era of nucleos(t)ide analogues. Best Practice and Research in Clinical Gastroenterology, 22(6), 1093–1108. doi:10.1016/j.bpg.2008.11.007