Which agents are used as first-line treatment for hepatitis B (HBV) (Hep B)?

Updated: Jun 08, 2021
  • Author: Nikolaos T Pyrsopoulos, MD, PhD, MBA, FACP, AGAF; Chief Editor: BS Anand, MD  more...
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Currently, pegylated interferon alfa (PEG-IFN-a), entecavir (ETV), and tenofovir disoproxil fumarate (TDF) are the first-line agents in the treatment of hepatitis B disease. These are the main treatment drugs approved globally for this disease, although ongoing trials are investigating new types of medications, such as tenofovir disoproxil in combination with emtricitabine (FTC). Encapsidation inhibitors, entry inhibitors, TLR7 agonists, and therapeutic vaccines are all in development.

In 2009, international phase III trials with clevudine (l-FMAU) for the treatment of chronic hepatitis B virus (HBV) infection were halted owing to a very high risk of myopathy. [63]

Lamivudine (3TC), telbivudine, and adefovir are of historical interest. These agents are currently considered second- or third-line therapy, or “nonpreferred” treatment. [64]

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