INTRODUCTIONManagement guidelines of chronic hepatitis B virus (HBV) infection have been regularly updated according to the recommendations of the American Association for the Study of Liver Diseases (1), European Association for the Study of the Liver (2), and the Asian Pacific Association for the Study of the Liver (3). Current treatment strategies for patients with chronic hepatitis B (CHB) are as follows: interferon alpha-based immunomodulation and nucleos(t)ide analog-based inhibition of viral replication. Interferon alpha is one of the signaling proteins known as cytokines that has several mechanisms of action, including direct antiviral, immunomodulatory, and anti-proliferative effects, while nucleos(t)ide analogs are polymerase inhibitors that target DNA elongation by inhibiting the reverse transcription of HBV. Thymosin alpha-1 and peginterferon lambda have been used as immunomodulatory agents, but their effectiveness was modest and far from satisfactory compared to interferon-alpha (4,5). In the last decade, despite remarkable advances in the therapeutic use of anti-HBV agents such as nucleos(t)ide analogs and interferon-alpha