Antiviral drugs used for chronic hepatitis B

Two classes of drugs are used to treat chronic hepatitis B—direct antiviral drugs (nucleoside/nucleotide analogues) and immunomodulatory drugs (interferons); see #ldg1-c06-s7-1__tldg1-c06-tbl3 for drug characteristics. In Australia, the majority of patients are treated with entecavir or tenofovir; a small minority receive peginterferon.

Hepatitis B treatments are funded by the Pharmaceutical Benefits Scheme (PBS) for people who have Medicare access and meet the criteria for treatment. For those without Medicare access, the cost of treatment can be significant. The cost of treatment is a particular concern for people who do not have Medicare access and who are seeking permanent residency in Australia. At the time of writing, the (10-year) cost of entecavir therapy is below the threshold for residency, while the cost of tenofovir typically exceeds it, and people taking tenofovir may be denied residency for this reason; guidance for clinicians is available on the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) website.