What is the optimal therapy for chronic hepatitis B?

Chronic infection with the hepatitis B virus infection remains a major problem worldwide despite some decrease in its incidence after improvement in public health policies and the utilization of hepatitis B vaccine. The clinical spectrum of the disease ranges from the asymptomatic carrier and individuals with mild liver injury to cirrhosis and hepatocellular carcinoma. During the past two decades there has been important progress in the field of viral hepatitis, and several drugs for the treatment of chronic hepatitis B have been developed and analyzed in clinical trials. Currently, two forms of therapy have been approved and are available for clinical practice: alpha interferon and lamivudine. Neither therapy is entirely satisfactory because of side effects and lack of universal responses. There is also controversy over which patients should be treated and what agent and regimen should be used. In this review we discuss the advantages and disadvantages of utilizing either drug, the response rates to therapy and what regimen should be used.