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Hepatitis B is a potentially life threatening liver infection caused by hepatitis B virus. It is mostly transmitted through mother to fetus, infected blood or during needle injury, surgery or dental procedures. Patients with hepatitis B experience symptoms e.g. yellowing of the skin and eyes, dark urine and abdominal pain. Currently, there are no specific treatments for acute hepatitis B while chronic condition can be treated with medicines to slow down the progression of cirrhosis, reduce the incidence of liver cancer and improve long term survival.

Nucleoside/Nucleotide analogue
Lamivudine is the first oral antiviral approved for hepatitis B. As long-term use of lamivudine can lead to antiviral resistance, it is no longer recommended. It is well tolerated without significant side effects.

Entecavir is the current first-line antiviral for hepatitis B. Compared to other antivirals, it is the most potent in suppressing hepatitis B virus and it rarely leads to antiviral resistance. It is well tolerated without significant side effects.

Tenofovir is another potent antiviral for hepatitis B. It is recommended for patients with antiviral resistance to other antivirals including lamivudine and entecavir. Long-term use of tenofovir may lead to nephrotoxicity and bone loss.