Introduction to antiviral therapy for hepatitis B

Antiviral therapy drugs for hepatitis B can be divided into two main groups: interferon analogs and nucleoside (acid) analogs. The former are injectable and come in long-acting and generic forms. The long-acting ones, also known as pegylated interferons, include pelargon (α-2b) and piroxin (α-2a); the common interferons also have two categories, α-2a and α-2b, and are currently marketed under various trade names by several manufacturers. In general, interferon is used to clear the virus by inducing the body’s immune response, and the HBeAg seroconversion rate is higher than that of the oral nucleoside class. However, the side effects are significant, such as flu-like syndrome (manifested as fever, chills, headache, muscle aches and weakness), transient myelosuppression (mainly manifested as peripheral blood leukocytes (neutrophils) and thrombocytopenia), psychiatric abnormalities (may manifest as depression, paranoia, severe anxiety and other psychiatric symptoms) and induction of autoantibodies and autoimmune diseases (including anti-thyroid antibodies, anti-nuclear antibodies and anti-insulin antibodies). anti-thyroid antibodies, anti-nuclear antibodies and anti-insulin antibodies), etc. It should not be used in patients with decompensated cirrhosis. Influenza-like syndrome and transient myelosuppression appear in the early stage of drug administration and may gradually decrease or disappear with the progress of treatment, but sometimes they may persist and affect the course of treatment. Nucleoside (acid) analogues: currently approved for clinical use are lamivudine, adefovir (Hovalix, Daidzein, Meizheng, etc.), telbivudine and entecavir. The dosage is once a day, one tablet each time. They are easy to use and have few side effects, but the course of treatment is long, and some of them are prone to viral resistance mutations, and there is a risk of worsening the disease after stopping them. It is important to emphasize that none of the regimens are 100% effective, so it is important to monitor regularly during treatment and adjust the regimen if necessary.