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World J Gastroenterol. Jan 14, 2014; 20(2): 401-413
Published online Jan 14, 2014. doi: 10.3748/wjg.v20.i2.401
Then and now: The progress in hepatitis B treatment over the past 20 years
Dina Halegoua-De Marzio, Hie-Won Hann
Dina Halegoua-De Marzio, Hie-Won Hann, Division of Gastroenterology and Hepatology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA 19107, United States
Hie-Won Hann, Liver Disease Prevention Center, Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, United States
Author contributions: Halegoua-De Marzio D and Hann HW contributed equally to this work.
Correspondence to: Hie-Won Hann, MD, Liver Disease Prevention Center, Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, 1025 Walnut Street, Philadelphia, PA 19107, United States. hie-won.hann@jefferson.edu
Telephone: +1-215-9555806 Fax: +1-215-9550770
Received: September 13, 2013
Revised: October 25, 2013
Accepted: November 28, 2013
Published online: January 14, 2014
Processing time: 127 Days and 17.1 Hours
Abstract

The ultimate goals of treating chronic hepatitis B (CHB) is prevention of hepatocellular carcinoma (HCC) and hepatic decompensation. Since the advent of effective antiviral drugs that appeared during the past two decades, considerable advances have been made not only in controlling hepatitis B virus (HBV) infection, but also in preventing and reducing the incidence of liver cirrhosis and HCC. Furthermore, several recent studies have suggested the possibility of reducing the incidence of recurrent or new HCC in patients even after they have developed HCC. Currently, six medications are available for HBV treatment including, interferon and five nucleoside/nucleotide analogues. In this review, we will examine the antiviral drugs and the progresses that have been made with antiviral treatments in the field of CHB.

Keywords: Chronic hepatitis B; Treatment of hepatitis B; Hepatocellular carcinoma; Nucleoside analogues; Nucleotide analogues

Core tip: Chronic hepatitis B virus (HBV) infection is one of the leading causes of death across the world due to its worldwide distribution and potential sequelae. Advances in knowledge in combination with the development of potent and effective antiviral therapy for chronic hepatitis B have led to decreased complications from the virus. Timely use of nucleotide/nucleosides may improve liver function and increase survival in patients with hepatic decompensation. Maintained suppression of HBV replication with antiviral therapy halts the progression of liver disease, may reverse liver fibrosis, and can reduce the development of cirrhosis and hepatocellular carcinoma.