38. What are the advantages and disadvantages of the current approved hepatitis B treatments?

To summarize what I’ve reviewed with you, and this is what I try to talk about with my patients, there’s advantages and disadvantages of our three therapies. I’ve only highlighted a few of them here. Interferon, and I haven’t discussed this, but there is about a 5%-8% chance with interferon you actually will lose the surface antigen, that’s higher than the other two therapies. It’s only a short duration of therapy, 4-6 months on average, it has to be given by shots and there are a lot of side effects. Both of the oral agents, they’re oral, there’s good tolerance you can use it in end stage liver disease, whether it’s cirrhosis or liver failure, and you use lamivudine in adefovir failures and adefovir in lamivudine failures. The disadvantages are that drug resistance is common, about 20% per year, where here you also have drug resistance but it’s less common. Now there are new studies from Berlin, they showed here loss of surface antigen in 2% of patients at one year, not bad. It’s not as high as interferon but it’s reasonable.