Management overview of chronic hepatitis B with established therapies

Currently available options for the treatment of chronic hepatitis B virus (HBV) infection include standard and pegylated interferon alfa and Thymosin alpha, four oral antiviral agents (lamivudine, adefovir, entecavir, and telbivudine), two agents Tenofovir and emtricitabine approved in the HIV HBV co-infection are likely to be approved for HBV infection in immediate future. These treatment strategies are either therapies of finite duration that aim to achieve sustained off-therapy responses, or long-term treatments that aim to maintain on-therapy remission. Most agents designed to target hepatitis B are hindered by the development of resistance, poor tolerability or limited efficacy; therefore, new agents and treatment strategies are needed. Although therapy of hepatitis B is evolving, which between single and/or combined agents are most effective, how long therapy should last, which criteria should be used to start or continue and switch or stop therapy are to be defined. This paper provides a review of management with the available treatment options for HBV associated liver diseases.