Hepatitis - Hepatitis B and D

Investigative Therapies.

Telbivudine is a nucleoside analog drug in Phase III trials for treatment of chronic hepatitis B. A 2003 study, presented at a meeting of the American Association for the Study of Liver Diseases, found that telbivudine resulted in significantly better suppression of HBV and normalization of certain liver enzymes compared to lamivudine monotherapy.
Pegylated interferon alfa-2b (Peg-Intron) is currently approved for treatment of chronic hepatitis C. It is being investigated alone and in combination with lamivudine for treatment of HBV. One 2005 study found that a third of patients treated solely with pegylated interferon-alfa-2b became negative for the hepatitis B antigen (HBeAg). Combining the drug with lamivudine did not improve effectiveness. Another 2005 trial tested a staggered drug regimen where pegylated interferon alfa-2b was administered alone and then later combined with lamivudine. Researchers compared the results with lamivudine single therapy and found that the combination group had better virologic response and less drug-resistance. However, there were more side effects in the combination drug group and the duration of the treatment regimen was longer.
Thymosin Alpha 1 (Zadaxin), also called thymalfasin, is a synthetic version of a peptide derived from the thymus gland (which is responsible for maturation of immune factors call T-cells). It appears to be safe for hepatitis B patients when used alone or in combination. It is approved in many countries, but not the United States.
Vaccines as Treatments. Hepatitis B vaccines are being investigated in combination with drugs, such as lamivudine, for treatment of HBV.

Liver Transplantation. If the disease progresses to the point where it becomes life-threatening, liver transplantation may be an option. It is not foolproof, however. Viral recurrence is high in hepatitis B patients, although it can be significantly reduced using monthly infusions of hepatitis B immune globulin (HBIg), particularly when used with lamivudine. These injections may need to be administered life long. Eventually, about 40% of patients develop resistance to lamivudine. In such events, alternative agents, such as adefovir, are proving to be effective.