[Management of chronic hepatitis B]

The features of chronic hepatitis B virus (HBV) related liver diseases and the aim of their therapy have briefly discussed, then treatment modalities are listed. In Hungary, between 1994 and 1996, a total of 68 patients with chronic hepatitis B have been treated with interferon (IFN). IFN resulted in complete clinical-biochemical remission in 50% of the patients, and in 32% the HBV replication was also eliminated. There are various nucleoside analogues, among them mostly famciclovir and lamivudine have been intensively studied as potentially effective treatment for HBV infection, and controlled clinical trials are in progress with these drugs. Nucleoside analogues in combination with IFN possibly improve treatment results in this disease. Various immunomodulatory agents--such as levamisole, thymosine, interleukin-2, and other cytokines--as well as the prednisolon-withdrawal induced rebound phenomenon have also been tested in HBV infection, but with no generally established benefit. A recombinant HBsAg vaccine is under investigation for therapeutic use. For end-stage HBV liver cirrhosis, liver transplantation is the only treatment, but the problem of reinfection is not still solved for more reasons.