Published online May 21, 2014. doi: 10.3748/wjg.v20.i19.5730
Revised: January 7, 2014
Accepted: March 4, 2014
Published online: May 21, 2014
Chronic hepatitis B (CHB) is currently medically managed with either interferon-alpha or one of the five nucleos(t)ide analogs. However, there are still a large number of CHB patients whose response to the above therapies remains less than satisfactory, and their incomplete or non-response to antiviral therapies has plagued clinicians worldwide. In recent years, a newly proposed optimization therapy has provided us with a new approach to solve this problem. The key points in this optimization therapy are to initiate antiviral therapy with an appropriate agent at the correct time point, and to adjust treatments in patients with poor early responses by adding a second agent or switching to another more potent agent. In this review, we summarize recent developments in optimization therapy for the treatment of CHB, and provide an outlook for future research in this field.
Core tip: Optimization therapy is a personalized strategy, and it aims to achieve profound and sustained inhibition of hepatitis B virus replication, and to reduce the likelihood of subsequent disease progression. The key points of optimization therapy are to initiate antiviral therapy with an appropriate agent at the correct time point based on baseline characteristics, and to timely adjust the treatment by dynamic monitoring of the on-treatment response. However, the current understanding of optimization therapy is still very limited, and many issues still need further research.