In the mid-1970s, interferon-alpha began to be used to treat chronic hepatitis B (CHB), but the response rate to interferon-alpha treatment was low.[sup][2] After 1998, five nucleos(t)ide analogs (NAs)-lamivudine (LAM), adefovir dipivoxil (ADV), telbivudine (LdT), entecavir (ETV), and tenofovir disoproxil fumarate (TDF) were successively introduced, leading to a continuous virologic suppression and control of disease progression in CHB patients.[sup][3] NAs can inhibit viral replication by suppressing the process of reverse transcription, but they have a small effect in reducing intrahepatic covalently closed circular DNA (cccDNA).[sup][4] Therefore, long-term treatment might be beneficial to achieve the ultimate goal of clearance of hepatitis B surface antigen (HBsAg).[sup][5]
One-year entecavir or lamivudine therapy results in reduction of hepatitis B virus intrahepatic covalently closed circular DNA levels.