Antiviral Therapy for

Chronic Hepatitis B
Oleh
Hajar Astuti A.
Pembimbing
dr. Zakaria Mustari, Sp.PD

*INTRODUCTION
Hepatitis B virus
1% in Japan (+ 1.5 million people
are believed to be infected)
Spontaneous remission

Asymptomatic carriers

Cirrhosis or liver cancer due to repeated cycles of

relapse and remission of hepatitis

*IFN Therapy
Characteristics of IFN Therapy
* Controls HBV-DNA proliferation and alleviates hepatic
inflammation through immunological mechanisms or
direct antiviral actions.
Timing to start IFN Therapy
* When HBeAg is (+), HBV-DNA is (+), and ALT level is
doubled or higher compared to the normal level.

* Nucleoside Analogue Therapy

Characteristics of Nucleoside Analogue Therapy
* Absorbed into blood and enter hepatocytes, become
activated and specifically inhibit the reverse
transcription step in hepatitis B virus replication
process.

* Nucleoside Analogue Therapy

* Lamivudine
100 mg/day for 52 weeks
* Adefovir
100 mg/day of Adefovir + 100 mg/day Lamivudine
* Entecavir
0.5 mg/day for 52 weeks

IFN

HBe Ag (-)
HBV DNA (-)
ALT
Normalization

Lamivudin

(+)

(+)

Adefovir +
Lamivudin

33%

12%

16%

96%

56% (6 months)
69% (12 months)
81% (24 months)

86% (6 months)
89% (12 months)

73% (6 months)
85% (12 months)
99% (24 months)

87% (6 months)
95% (12 months)

37%

17%

Entecavir
-

* Conclusion
* Compared

with the IFN therapy described above,

nucleoside analogue therapy is a very revolutionary
treatment method. They are simpler to administer for they
are oral medications, their effects to control HBV-DNA
proliferation are evident, and they have few side effects.
* However, there are also problems; hepatitis may relapse
when the treatment is discontinued, and resistant viruses
can emerge as a result of prolonged administration. These
problems must be considered before nucleoside analogue
therapy is conducted.

THANK YOU