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British Medical Bulletin 46:368-382 (1990)
© 1990 The British Council

research-article

Antiviral therapy: Hepatittis B

M R Jacyna and H C Thomas

Department of Medicine and Hepatology, St Marys Hospital Medical School, Imperial College, University of London London

Abstract

Antiviral therapy for chronic hepatitis B virus infection can result in clearance of replicating virus from the liver and prevention of progression to cirrhosis in a substantial proportion of patients. Adenosine arabinoside monophophate, a potent inhibitor of HBV replication, is of limited usefulness because it causes significant neuromuscualr toxicity. Acyclovir alone is relatively non-toxic, but is clinically ineffective in eliminating HBV from the liver. Lymphoblastoid or recombinant alpha-intereferons are the best option at present and offer up to a 50% chance of long-term inhibition of HBV replication (with only minor side-effects) in patients who acquire the infection in adulthood. However alpha-interferon therapy alon is not effective whrn infection is acquired from birth. In this latter group of patients, prednisolone pre-treatment followed by alpha-interferon is currently under evaluation.


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