Comparison of entecavir and telbivudine in management of chronic Hepatitis B

The currently available options for the treatment of chronic hepatitis B virus (HBV) infection include standard and pegylated interferon alfa and four oral antiviral agents (lamivudine, adefovir, entecavir, and telbivudine). These treatment strategies are either therapies of finite duration which aim to achieve sustained off-therapy responses or long term treatments that aim to maintain on-therapy remission. Most agents designed to target hepatitis B are hindered by the development of resistance, poor tolerability or limited efficacy; therefore, new agents and treatment strategies are needed. Pegylated interferon alfa may offer higher sustained off-therapy responses after one year, but most patients do not respond. Oral antivirals are the only candidates for long term treatment of patients with chronic HBV infection. Viral suppression has favorable effects on outcome outcome and modifies the natural history of the disease. The oral nucleos(t)ide analogues are generally better tolerated than interferon. This article attempts to provide an overview of the data available on the two new drugs entecavir and telbivudine.