Oral Antiviral Therapies for Achieving Sustained Viral Suppression in Adults with Chronic Hepatitis B: A Systematic Review on Efficacy and Associated Outcomes

Chronic Hepatitis B be easily managed through antiviral therapies that significantly reduce viral load, thereby decreasing liver inflammation and slowing the progression of liver fibrosis and cirrhosis of a patient. However, their clinical efficacy and safety has yet to be thoroughly determined. Different treatment varies widely in terms of effectiveness and safety concerns, with each treatment’s extremity. Moreover, they often elicit different responses across patients due to factors influencing their efficiency such as their age, liver health and immune health status. In this systematic review, we will investigate the different oral antiviral therapies for achieving sustained viral suppression in adults with their efficacy and their corresponding outcomes. 12 various studies were collected using relevant databases like PubMed, Web of Science and Scorpus across Asia and had been analyzed and reviewed. This study evaluated four antiviral drugs including entecavir (ETV), tenofovir (TDF), lamivudine (3TC), and telbivudine (LdT) with treatment variations varied from 1 to 5 years aiming to assess the patients’ varying degrees of efficacy such as ALT levels and HBeAg status after receiving the treatment. When comparing the therapeutic medicines, Tenofovir was determined to be effective in reducing viral load (3.4 ± 1.4 log10 IU/mL) and ALT levels (46.9 ± 49.8 U/L) in patients with mild to moderate liver inflammation. On the other hand, lamivudine exhibits moderate ALT levels (74.4± 94.7 U/L) and viral loads (6.88 ± 0.62 log10 IU/mL), making this treatment suitable for those experiencing moderate inflammation and requiring effective viral suppression and telbivudine displayed a notable ability to induce both HBeAg seroconversion of 46.4% and HBsAg loss of 31.1%. Overall, Entecavir consistently exhibited superior performance with 99. 4% in viral suppression and 94.5% liver function improvement.