Hepatitis B and D: Interferon‐Based Therapy—For Clinical Trials or Standard of Care—Back to the Future?

ABSTRACT

Interferon (IFN) has historically played a major role in chronic viral hepatitis B and D management over the last three decades. Widening utilisation of nucleoside/nucleotide analogues (NUCs) for hepatitis B viral suppression, which have a better side‐effect profile, alongside the recent licensing of bulevirtide for treatment of hepatitis D, means that its clinical use has further declined. Pegylated‐interferon alpha (peg‐IFNα) treatment is suboptimal with poor tolerability and achieves durable clearance of hepatitis B and D in only a limited number of patients. Nevertheless, its use in hepatitis B has significantly increased the number of patients achieving hepatitis B surface antigen (HBsAg) loss compared to those on NUCs alone. Evidence has shown that peg‐IFNα is also associated with overall improved long‐term clinical outcomes in chronic hepatitis D, even for the many whose hepatitis D viral load rebounds after discontinuation. Clinical trials have recently focused on peg‐IFNα in combination with novel antiviral therapies in the goal for finite cure in hepatitis B and D. This article focuses on recent research advances, examining if peg‐IFNα treatment may still play an important role in hepatitis B and D treatment.