Leading articles Current and future antiviral agents for chronic hepatitis B

Effective antiviral therapy for chronic hepatitis B virus (HBV) infection is important since ∼400 million people are affected globally. Loss of hepatitis B e antigen (HBeAg) with or without seroconversion to antibody against HBeAg (anti-HBe), normalization of alanine aminotransferase (ALT) and improvement in liver histology are the usual short-term end-points of therapy.1 To determine whether the ultimate treat-ment target, i.e. prevention of cirrhosis-related complications and hepatocellular carcinoma (HCC), is achieved requires more long-term follow-up of treated patients.1 The two established agents for the treatment of chronic hepatitis B are interferon (IFN)-α and lamivudine. Adefovir dipivoxil has also been licensed recently in the USA and in Europe. Their main modes of action are immunomodulation and direct suppression of viral replication. IFN-α induce