ABSTRACT
Approximately 450 million people worldwide have persistent hepatitis B and C virus infection, many of whom live in developing countries. The treatment of hepatitis B virus infection (HBV), stimulated by the successful treatment of human immunodeficiency virus (HIV) with nucleoside analogues, is entering a new and potentially exciting phase, but remains challenging. It is likely that the coming decade will see the successful treatment of HBV with combinations of nucleoside analogues and immunomodulatory therapies. Unfortunately, as with human immunodeficiency virus infection, it is likely that these drugs will not be affordable in developing countries where they are needed most, unless expanded access programmes are developed. An effective vaccine for HBV has been available since 1982 and universal vaccination programmes have been implemented in more than 100 countries (but excluding the UK). These programmes have reduced the transmission rate of HBV. Universal vaccination of newborns worldwide remains a major therapeutic and economic challenge.
