Interferon or nucleoside analogs as options for compensated hepatitis B cirrhosis

Interferon interferon has both antiviral and immunomodulatory effects, can make a certain percentage of patients obtain continuous suppression of viral replication or even viral clearance (HBsAg negative), can significantly reduce the incidence of hepatocellular carcinoma in patients with HBV-related cirrhosis, some studies show that: the same interferon treatment for 1 year, cirrhotic patients have a significantly higher rate of clearance of HBeAg than non-cirrhotic patients, respectively, 59% versus 24%. The clearance rate of HBeAg in cirrhotic patients was significantly higher than that in non-cirrhotic patients, 59% versus 24%. Therefore, some scholars believe that if there is no contraindication and exclude acute exacerbation of hepatitis, IFNα can be used as the first line of antiviral drugs for HBV DNA-positive cirrhotic patients in good compensated stage. Dosage and course of treatment: regular interferon, 500 WIU subcutaneously, every other day; polyethylene glycolated interferon (α-2a), 180 μg, subcutaneously, once a week. The course of treatment is 1 year. In the course of medication, the condition should be closely observed, and the drug should be stopped early if there are obvious contraindications to interferon application. Nucleoside analogs This class of drugs has a strong inhibitory effect on HBV, and can significantly improve liver function and liver tissue inflammation, necrosis and fibrotic lesions. Lamivudine, adefovir, entecavir and tebivudine are available. Currently there are trials showing that continuous oral administration of lamivudine in patients with compensated cirrhosis reduces the risk of hepatic decompensation and the development of primary hepatocellular carcinoma (HCC), but the incidence of resistance to the drug is relatively high with this drug, whereas the incidence of resistance to adefovir ester and entecavir is low, thus making them more suitable for long-term oral administration.