| Abstract | Chronic hepatitis B infection (CHB) is the major cause of liver disease in Asia, resulting in significant morbidity and mortality in a quarter of the patients. A 4-prong approach from all healthcare providers is needed -- [a] prevention by vaccination; [b] identification of CHB carriers; [c] development of effective therapeutic regimen; and [d] early detection of hepatocellular carcinoma (HCC). Understanding of the natural history among Asian carriers is of vital importance in the management of CHB patients. There are three main stages -- [a] immune tolerance; [b] immune clearance; and [c] quiescence. The ultimate goals of therapy is to prevent complications and improve survival by eradicating the virus, resolving hepatitis and preventing the progression to cirrhosis and HCC. Interferon has certain efficacy, but has certain side-effects and is costly. Recent advances in the development of antiviral agents open up more hope. These include lamivudine, famciclovir, lobucavir, adefovir, FTC, thymosin, interleukin 12 and therapeutic vaccines. Combination of agents is the logical approach to achieve the therapeutic goals. |
|---|
