More than two billion people worldwide have been in contact with the hepatitis B virus (HBV) and around 400 million are chronically infected. The annual number of deaths from HBV-associated liver disease - mainly cirrhosis or hepatocellular carcinoma (HCC) - is more than 500,000. An estimated 0.4% of the Dutch population, about 64.000 persons, are chronically infected with the virus, and 2.1% suffered an HBV-infection. In spite of the availability of a safe and effective vaccine for over 20 years now, HBV-infection remains an important health problem. The treatment of chronic HBV-infection has much improved over the past decade. With interferon alpha still the only registered treatment option for hepatitis B in the early 1990s, the list of registered medications now includes seven drugs: interferon alpha, lamivudine, adefovir, peginterferon alpha, entecavir, telbivudine and tenofovir. No doubt many other drugs will follow within the next few years. The clinical scientific research in our department has a special focus on treatment of chronic hepatitis B.

Recently completed studies
Long-term follow-up of pegylated interferon alpha-2b and lamivudine combination therapy in patients with chronic HBV infection.
This international study, initiated by Erasmus MC, evaluated long-term outcomes after treatment with peginterferon alone or in combination with lamivudine. The results were presented at the most recent meeting of the American Association for the Study of Liver Diseases (AASLD) and will probably be published soon.

The effects of α-galactosylceramide on chronic hepatitis B infection in a randomized placebo controlled phase I/II trial.
This study aimed to determine the effect of different dosages of α-galactosylceramide, a drug that might stimulate the immune system, in patients with chronic hepatitis B virus infection followed by Erasmus MC. The results were presented at the most recent meeting of the American Association for the Study of Liver Diseases (AASLD) and will probably be published soon.

A randomised, double-blind, comparison of tenofovir disoproxil fumarate versus adefovir dipivoxil for the treatment of HBeAg positive chronic hepatitis B.
Erasmus MC participated in this large-scale international study in which the new antiviral drug tenofovir was compared to adefovir, which was already registered. The results were presented at the most recent meeting of the American Association for the Study of Liver Diseases (AASLD).

A Comparison of Entecavir and Lamivudine for HBeAg-Positive Chronic Hepatitis B.
In this large-scale international study in which the new antiviral drug entecavir was compared to lamivudine, which was already registered. Erasmus MC was one of the largest participating centres in this study. The results have been published in the leading medical journal The New England Journal of Medicine.

Pegylated interferon alpha-2b alone or in combination with lamivudine for HBeAg-positive chronic hepatitis B: a randomised trial (HBV99-01 study).
This international study, initiated and coordinated by Erasmus MC, evaluated the effectiveness of peginterferon alpha-2b - either alone or in combination with lamivudine - in 266 patients with HBeAg-positive chronic hepatitis B. The results have been published in the leading medical journal The Lancet.

Current studies
Augmenting response to entecavir using a temporary peginterferon alpha-2a add-on strategy for the treatment of HBeAg-positive chronic hepatitis B.
This study, initiated by the Erasmus MC department of Gastroenterology and Hepatology, aims at investigating the effect of temporary addition of peginterferon alfa-2a to entecavir treatment.