Chronic hepatitis B: the therapeutic challenge

With over 350 million chronic carriers of the hepatitis B virus (HBV) worldwide and the realization that chronic carriage leads to the clinical sequelae of liver cirrhosis and hepatocellular carcinoma, control of hepatitis B has emerged as one of the significant public health challenges of the decade. The implementation of universal infant immunization has already had an effect on the burden of chronic liver disease, but what is to be done with the existing pool of carriers? In most countries, the only currently licensed treatment is interferon- alpha but this is effective in less than a third of selected patients.