There may be about one million patients with HBV in the US.
Chronic hepatitis B is much less common than chronic hepatitis C in the United
States. Patients with chronic HBV have more effective options than patients
with HCV. We have 3 FDA oral medications that are well tolerated and are very
Lamivudine 100-150 mg daily often works but resistance occurs commonly. I like
to start with this drug because is usually works and it is very well tolerated.
Adefovir 10 mg daily works in most patients and some doctors use it as first
line therapy for HCV. I use it for lamivudine failures.
Tenofovir 300 mg daily is FDA approved for HIV, but it works well for HCV, maybe
better than adefovir, which is made by the same company.
Entacavir is a new oral medication for HBV approved by the the
Interferon can be used. Pegasys is an interferon that can be taken once per
week for 48 weeks.
Hepatitis B is a more complicated virus to treat than hepatitis C. Patients
with Hepatitis B cannot completely eliminate the virus from their bodies. The
goal in treating HBV is to reduce the HBV-DNA level in the blood to an undetectable
level. Patients who are positive for HBeAg should convert to HBeAb with successful
treatment. A minority of patients will convert their HBsAg to HBsAb with antiviral