[Therapy of chronic hepatitis B infection]

Around 350 million people worldwide are chronically infected with the hepatitis B virus. In adults around 5% and during perinatal contact around 100% of the infections become chronic. The main complications of chronic HBV infection are liver cirrhosis and hepatocellular carcinoma. Therefore after chronic HBV infection has been diagnosed early therapy has to be considered. At present two drugs are available: Interferon-alpha and lamivudine. Therapy with Interferon-alpha is successful in 30-40% of the patients. In contrast, the initial response rate during lamivudine therapy is very good. However, in many of the patients mutant HBV strains are selected. Therefore in each patient it has to be considered individually which of the two drugs should be used. In this review these questions will be addressed and a special focus will be the use of lamivudine. Additionally future treatment options will be discussed.