Korean J Gastroenterol.  2008 Jun;51(6):338-345.

Management of Chronic Hepatitis B in Treatment-Naive Patients

• Cheong JY

Abstract

Chronic hepatitis B (CHB) is a serious health problem in Korea. The natural history of chronic HBV infection has been divided into 4 phases: immune tolerance, immune clearance, inactive HBsAg carrier state and reactivation. During the phases of immune tolerance and inactive HBsAg carrier state, no treatment is required. Patients in the immune clearance or reactivation phases are candidates for therapy. In the last years, treatment effects of CHB have considerably improved. Several agents are currently approved for the treatment of CHB: interferon alpha, pegylated interferon alpha, lamivudine, adefovir, entecavir, telbivudine and clevudine in Korea. The treatment recommendations from the 2004 Korean Association for the Study of the Liver guideline on the management of CHB have been updated to incorporate new therapeutic options. What is uncertain is which agent or combination of agents is most effective, how long therapy should last, and which criteria should be used to start, continue, switch or stop therapy. Issues for consideration include efficacy, safety and incidences of resistance, and method of administration of antiviral therapy in treatment-naive patients.

Keyword

Chronic hepatitis B; Treatment

MeSH Terms

Adenine/analogs & derivatives/therapeutic use
Antiviral Agents/*therapeutic use
Arabinofuranosyluracil/analogs & derivatives/therapeutic use
Guanine/analogs & derivatives/therapeutic use
Hepatitis B, Chronic/*drug therapy
Humans
Interferon Alfa-2a/therapeutic use
Interferon Alfa-2b/therapeutic use
Korea
Lamivudine/therapeutic use
Phosphonic Acids/therapeutic use
Polyethylene Glycols/therapeutic use
Practice Guidelines as Topic