Tenofovir for HBV: The beginning of the end or the end of the beginning?

Patients with Hepatitis B virus infection may present to the treating clinicians at various stages of natural history of hepatitis B infection, including acute viral hepatitis, chronic active hepatitis, incidental hepatitis B s antigen-positive patients and those with decompensated cirrhosis and hepatocellular carcinoma. Management of chronic hepatitis B patients, especially those with e antigen-negative disease poses the biggest challenge today. There are various treatment options available and choosing the correct drug according to the patient profile is important both for optimum response and preventing drug resistance. This article reviews an exciting new molecule tenofovir, which has been approved in August 2008 by the US Food and Drug Administration for treatment of chronic hepatitis B.