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.
37. What is the treatment algorithm for patients with decompensated cirrhosis?
39. Are there new treatments on the horizon for treatment of chronic hepatitis B?