Global perspectives: Australia - Real world experience with HBV antiviral therapy.

Abstract

The management of chronic hepatitis B (CHB) in Australia is associated with a number of challenges including future projections of a major rise in CHB related complications such as hepatocellular carcinoma and the presence of a considerable pool of patients with resistance to multiple antivirals. Entecavir, tenofovir and pegylated interferon are considered the first line agents of choice based on results from large controlled studies but there is an additional need for 'real-world' data as well. Outcomes from everyday practice settings are more likely to reflect the challenges of managing heterogeneous patient populations with multiple co-morbidities and less predictable adherence rates than in controlled trials. In this review we summarise a series of real world studies in an Australian CHB population that demonstrate pegylated interferon and entecavir have rates of efficacy and tolerability comparable to the large controlled trials. We also review the prevalence of resistance mutations in this country and the effectiveness of tenofovir in a heavily treatment exposed CHB population. © Springer Science+Business Media New York 2012.