Why do we not yet have combination chemotherapy for chronic hepatitis B?

Abstract

• Despite the emergence of multidrug-resistant strains of hepatitis B virus (HBV) and previous success with combination therapy for other chronic viral infections, we are still using sequential monotherapy for chronic HBV infection. • Antiviral-resistant HBV can result in major life-threatening complications. • We now have complementary drugs, such as lamivudine and adefovir dipivoxil, with fundamentally different structures and associated with different signature resistance mutations, with adefovir dipivoxil showing antiviral activity against most lamivudine-resistant strains. • Studies of combination therapy to date have used traditional endpoints - short-term reduction of HBV DNA levels a..