Medical Therapy

Until 10 years ago, interferon alfa-2b was the only medication approved by the U.S. Food and Drug Administration for treating hepatitis B. Given by injection several times a week for six months to a year, sometimes longer, the drug modulates the immune system against the viral infection. It can cause side effects such as flulike symptoms, depression, and headaches.

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Pegasys, pegylated interferon, is a longer-acting interferon approved for treating adults with chronic hepatitis B in 2005. Given by injection once a week for six months to a year, the drug can cause side effects similar to interferon alfa-2b.

Epivir, or lamivudine, is a once-a-day pill taken for a year or longer that was approved in 1998. In large placebo-controlled clinical trials, patients treated with lamivudine therapy for 52 weeks had a significantly greater frequency of response compared with a placebo treatment (55 percent vs. 25 percent), in that the drug suppressed the viral load and normalized liver enzymes. However, long-term treatment with lamivudine causes significant viral mutation (up to 70 percent over five years); the effectiveness of other drugs decreases once mutation has occurred.

Hepsera, or adefovir-dipivoxil, is a pill taken once a day for a year or longer. It was approved for adults in 2002. However, kidney problems can occur while taking the drug.

Baraclude, or entecavir, a once-a-day pill, seems to have fewer side effects than some other hepatitis B treatments. The drug is a potent antiviral, approved by the FDA in 2005 for adults with chronic hepatitis B.

Tyzeka, or telbuvidine, is a once-a-day pill approved by the FDA in late 2006 for hepatitis B treatment. In clinical studies, the drug was more potent than lamivudine.