Table 2.
Antiviral agents |
Immunomodulators |
Nucleos(t)ide analogues |
||||||
IFN-α | PEG-IFN-α | Thymosin | Lamivudine | Adefovir | Entecavir | Telbivudine | Tenofovir | |
Route | SC | SC | Oral | Oral | Oral | Oral | Oral | Oral |
Dose | 5-10 MIU tiw | 180 μg qw | 1.6 mg biw | 100 mg od | 10 mg od | 0.5-1 mg od | 600 mg od | 300 mg od |
Year approved | 1992 | 2005 | Asia only | 1998 | 2002 | 2005 | 2006 | 2008 |
Antiviral effects | ||||||||
HBV DNA | 37 | 30 | 42 | 36-40 | 21 | 67 | 60 | 76 |
HBsAg clearance | ++ | ++ | N/A | - | - | + | - | - |
HBeAg seroconversion | 20-40 | 27 | 40 | 18-20 | 12 | 21 | 22 | 21 |
ALT normalization | 39 | 42 | 62-77 | 48 | 68 | 77 | 68 | |
Histological improvement | 38 | N/A | 56-62 | 53 | 72 | 65 | 74 | |
Side effects | Many | Many | Negligible | Negligible | Nephrotoxicity | Negligible | Negligible | Nephrotoxicity |
Contraindications | Numerous | Numerous | Uncommon | Uncommon | Uncommon | Uncommon | Uncommon | Uncommon |
Drug resistance (treatment-naïve patients) | ||||||||
1 yr | None, but non-response | 24 | None | 0 | 4 | 0 | ||
2 yr | 38 | 3 | 0.2 | 25 | 0 | |||
> 5 yr | 80 | 29 | 1 | N/A | 0 | |||
Drug resistance (LAM resistant patients) | ||||||||
2 yr | None, but non-response | N/A | 25 | 9 | N/A | 0 | ||
4 yr | N/A | N/A | 39 | N/A | 0 |
PEG-IFN: Pegylated interferon; SC: Subcutaneous; tiw: Three times a week; qw: Once a week; biw: Twice a week; od: Once daily; ALT: Alanine transaminase; ETV: Entecavir; LAM: Lamivudine; ADV: Adefovir; TBV: Telbivudine; TDF: Tenofovir disoproxil fumarate; N/A: Not applicable.