Table 1.
Current treatment concepts for hepatitis B
| Interferon | Nucleos(t)ide analog | |
|---|---|---|
| Drug(s) of choice | pegylated interferon alfa-2a, 180 μg, sc, 1×/week | tenofovir 245 mg, po, QD or entecavir 0.5 mg, po, QD |
| Treatment duration | 48 weeks, response-guided | long-term |
| Treatment in liver cirrhosis | not recommendeda | safe, even in liver cirrhosis |
| Advantages | finite treatment duration, no resistance, higher rates of seroconversion with 48 weeks of therapy | potent antiviral effect, good tolerance, oral administration, safe also in advanced liver diseases |
| Disadvantages | moderate antiviral effect, inferior tolerability, risk of adverse events, parenteral administration | indefinite duration (?), potential risk of resistance, concerns about long-term safety (renal, osteopenia) |
a
Pegylated interferon is the treatment of choice in patients with delta hepatitis (HBV–HDV co-/superinfection), but is strictly contraindicated in decompensated cirrhosis.