Treatment of hepatitis B

Area of Science:

• Hepatology
• Virology
• Internal Medicine

Background:

• Hepatitis B virus (HBV) is a significant global health concern, frequently causing cirrhosis and hepatocellular carcinoma.
• The progression of HBV infection is influenced by factors such as the age of acquisition and viral markers like hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), and HBV DNA levels.
• Chronic HBV infection is defined by persistent elevation of alanine aminotransferase (ALT) and the presence of HBsAg for over six months, indicating active viral replication.

Purpose of the Study:

• To outline the management of chronic active Hepatitis B virus infection.
• To discuss the therapeutic goals, including viral replication suppression and viral clearance.
• To review the efficacy and side effect profiles of available treatments: interferon alfa and lamivudine.

Main Methods:

• Review of current medical literature on Hepatitis B virus infection and its treatment.
• Analysis of clinical data regarding the effectiveness and adverse events associated with interferon alfa and lamivudine therapies.
• Identification of treatment endpoints, such as normalization of ALT levels and elimination of HBeAg and HBV DNA.

Main Results:

• Interferon alfa demonstrates efficacy in 25%–40% of patients but is associated with significant side effects.
• Lamivudine achieves similar efficacy rates (25%–40%) with a more favorable side effect profile.
• A key limitation of lamivudine is the potential for viral mutations and the development of drug-resistant HBV strains.

Conclusions:

• Treatment for chronic active HBV is indicated to control viral load and prevent disease progression.
• Both interferon alfa and lamivudine offer therapeutic benefits but present distinct challenges regarding side effects and drug resistance.
• Further research into novel therapeutic strategies is warranted to overcome the limitations of current HBV treatments.