Update on the management of chronic hepatitis B

Chronic hepatitis B virus infection is common and may cause significant disease morbidity, including chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Hepatitis B surface antigen-positive patients should have a detailed serologic evaluation including determination of the level of replication. Patients with high levels of virus replication and those with co-infection should be considered for treatment. Interferon was the first approved therapy for chronic hepatitis B and remains one of the most effective options. Newer agents, such as lamivudine and adefovir dipivoxil, offer excellent antiviral activity and ease of administration, although drug resistance is common with lamivudine.