Is it better to choose interferon or nucleoside analogues for the treatment of chronic hepatitis B?

  The two classes of drugs currently used for the antiviral treatment of chronic hepatitis B are interferon and nucleoside analogues. Short-acting interferon requires treatment every 1-2 days, while long-acting interferon (pegylated interferon) requires treatment only once a week. There are more manufacturers of short-acting interferon, while pegylated interferon is currently listed in China only two: the trade name is Pyroxin, Pellegrin; nucleoside drugs are currently listed in China four kinds, lamivudine (trade name: Heoptin), adefovir (trade name: Heveley, Daidin, Mingzheng), entecavir (trade name: Boludin) and telbivudine (trade name: Sulbivir). Both classes of drugs have their own advantages and disadvantages. Interferon and nucleoside analogues both have inhibitory effects on hepatitis B virus, while interferon has anti-liver fibrosis, immunomodulatory and direct antiviral effects in addition to hepatitis B virus inhibition.  Nucleoside analogues: they have a strong viral inhibitory effect on most patients, and can quickly inhibit hepatitis B virus replication in the short term, and are easy to take, only once a day (one tablet), with minimal side effects, and most patients can accept them, but for “major triplets” to “minor triplets “The effect is slow, the efficacy is unstable, the medication time is long, the course of treatment is uncertain, drug resistance and rebound after discontinuation are easy to occur, therefore, it must be taken under the guidance of a doctor and cannot be discontinued casually.  Interferon: The course of treatment is 6 to 12 months, and the purpose of treatment is clear: after treatment, “major triplet” turns into “minor triplet”, DNA turns negative, serum transaminases return to normal, and the efficacy is quite stable after stopping the drug. However, interferon is injected subcutaneously or intramuscularly, so it is not very convenient to use and store, and there are some side effects, the most common of which is more hair loss than usual during treatment. The most common side effects are hair loss during the treatment period. Because interferon is effective by stimulating the patient’s immunity, each person’s response to interferon is different, and the efficacy varies greatly. Only about 50% of the patients can achieve the conversion from “major triplet” to “minor triplet”, DNA conversion and normalization of serum aminotransferase after one course of treatment.