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Immunoprophylaxis and treatment of viral hepatitis B.

It is evident that new vistas have been opened with the advent of antiviral and other novel drugs. Most of the studies performed to date, however, have involved too few patients, have not been double-blinded, or have been entirely uncontrolled. In essence, these represent phase II studies. Because the HBsAg-carrier state is dynamic in that viral markers are generally in a state of flux, and because it is important to determine risk as well as benefit, no conclusions can be reached without an adequately designed double-blind, controlled study. At present, the most promising therapy seems to be the antiviral drugs, particularly interferon and Ara-A (or Ara-AMP). Still to be determined are the appropriate dose, appropriate duration of treatment, the extent of toxicity, and the validity of combination therapy. Also important is the development of simpler and less expensive ways of producing interferon. A potentially exciting and productive era appears about to open.