Reviews for APASL guidelines: immunomodulator therapy of chronic hepatitis B

Abstract The primary aim of immunomodulator therapy is to help the natural human immune system to mount a defense against hepatitis B virus. IFN-α has been used for the treatment of HBeAg-positive and HBeAg-negative chronic hepatitis B for over two decades and has been shown to be effective in suppr...
Ausführliche Beschreibung

Abstract The primary aim of immunomodulator therapy is to help the natural human immune system to mount a defense against hepatitis B virus. IFN-α has been used for the treatment of HBeAg-positive and HBeAg-negative chronic hepatitis B for over two decades and has been shown to be effective in suppressing HBV replication and in inducing serological response leading to long-term clinical benefits. IFN-α has been used in patients with well-compensated cirrhosis with comparable or better response to that in non-cirrhotic patients. IFN-α therapy in patients with cirrhosis has a similar side effect profile as in those without cirrhosis. However, IFN-α is contraindicated in patients with overt or decompensated cirrhosis. Pegylated IFN-α has been shown to be effective in treatment of chronic hepatitis B with sustained response rate in about one-third of the treated patients. Peg IFN-α treatment in non-responders to lamivudine or adefovir dipivoxil showed similar response rate to that seen in naïve patients. Thymosin $ α_{1} $ is effective in treatment of HBeAg-positive and HBeAg-negative chronic hepatitis B with a significantly increasing virological response over time after therapy. Ausführliche Beschreibung