Antiviral Agents Used to Treat Hepatitis B Virus Infection

Authors: H. Nina Kim, MD, MSc Chloe L. Thio, MD

Last updated: January 20, 2010

A 38-year-old Vietnamese woman with HBeAg-positive chronic hepatitis B presents for evaluation. She has had serum alanine aminotransferase (ALT) levels of 80-120 U/L and HBV DNA level of 2 million copies/mL (approximately 400,000 IU/ml) over the past year and no evidence of spontaneous loss of HBeAg. She is asymptomatic and had a normal abdominal ultrasound within the prior 6 months. She has never received therapy for hepatitis B.

Which of the following statements is TRUE regarding the use of available therapeutic agents for patients with chronic hepatitis B infection?

A A major drawback for the use of peginterferon alfa-2a (Pegasys) is the rapid development of HBV resistance.
B Telbivudine (Tyzeka) and lamivudine (Epivir-HBV) are both L-nucleoside analogues that share cross-resistance.
C Tenofovir (Viread) should not be considered an option for this patient because of the unacceptably high incidence of tenofovir-induced renal failure in Asian patients.
D The same dose of entecavir (Baraclude) can be used for treatment-naïve patients and lamivudine-resistant patients.