Should treatment indications for chronic hepatitis B be expanded?

Antiviral therapy has greatly improved the outcomes of patients with chronic hepatitis B virus (HBV) infection and active liver disease or advanced fibrosis/cirrhosis. However, current treatment does not eradicate HBV and long-term treatment is needed in most patients to maintain clinical benefit. Thus, professional society guidelines do not recommend treatment of all patients with chronic HBV infection. This review article will examine evidence for and against expansion of treatment to patients in whom treatment is not recommended based on current guidelines.
Source: Clinical Gastroenterology and Hepatology - Category: Gastroenterology Authors: Source Type: research

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The objective is that the combination of YinQiSanHuang-antiviral decoction with entecavir will reduce the annual incidence of liver fibrosis/cirrhosis to 1%.MethodsThis is a multicenter, randomized, placebo-controlled, double-blinded trial involving five hospitals. A total of 802 patients are randomly allocated to two groups: the YQSH group (n = 401) or the placebo group (n = 401). The YQSH group receives YQSH with entecavir; the placebo group receives granules of placebo with entecavir. Patients receive treatment for 52 weeks and then are followed up for 52 ± 2&thins...
Source: Trials - Category: Research Source Type: clinical trials
Publication date: Available online 18 February 2020Source: Antiviral ResearchAuthor(s): Shu Shi, Mingchen Liu, Jingyuan Xi, Hui Liu, Guiwen Guan, Congle Shen, Zhengyang Guo, Ting Zhang, Qiang Xu, Dilidaer kudereti, Xiangmei Chen, Jie Wang, Fengmin LuAbstractHepatitis B virus (HBV) infection is still a health care crisis in the world, and a considerable number of chronic hepatitis B patients die of end-stage liver diseases, including liver cirrhosis and hepatocellular carcinoma. A previous study has reported that sex-determining region Y box 4 (SOX4) promotes HBV replication by binding to the AACAAAG motif in the viral geno...
Source: Antiviral Therapy - Category: Virology Source Type: research
Abstract HBV is the most common etiology of both liver cirrhosis and hepatocellular carcinoma in Korea. Despite much progress made, the currently available antiviral therapies cannot eradicate or eliminate this virus. Hence, the benefits and risks of antiviral therapy should be carefully evaluated on an individual basis and within the context of the clinical situation. The ultimate goals of treatment are to decrease the mortality from liver disease. The benefits of antiviral therapy come from prevention of progression of liver disease. Understanding the natural history of chronic HBV infection is a key step in the...
Source: Korean J Gastroenter... - Category: Gastroenterology Authors: Tags: Korean J Gastroenterol Source Type: research
Authors: Tao Y, Wu D, Zhou L, Chen E, Liu C, Tang X, Jiang W, Han N, Li H, Tang H Abstract Chronic hepatitis B (CHB) remains the leading cause of liver-related morbidity and mortality across the world. If left untreated, approximately one-third of these patients will progress to severe end-stage liver diseases including liver failure, cirrhosis, and hepatocellular carcinoma (HCC). High level of serum HBV DNA is strongly associated with the development of liver failure, cirrhosis, and HCC. Therefore, antiviral therapy is crucial for the clinical management of CHB. Current antiviral drugs including nucleoside/nucleot...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
Authors: Wang J, Huang H, Liu Y, Chen R, Yan Y, Shi S, Xi J, Zou J, Yu G, Feng X, Lu F Abstract Chronic hepatitis B virus (HBV) infection remains to be a serious threat to public health and is associated with many liver diseases including chronic hepatitis B (CHB), liver cirrhosis, and hepatocellular carcinoma. Although nucleos(t)ide analogues (NA) and pegylated interferon-α (Peg-IFNα) have been confirmed to be efficient in inhibiting HBV replication, it is difficult to eradicate HBV and achieve the clinical cure of CHB. Therefore, long-term therapy has been recommended to CHB treatment under the curren...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
Chronic hepatitis B (CHB) is the common chronic viral infection worldwide, affecting approximately 350million people. [1] Because persistently high hepatitis B virus (HBV) replication is associated with an increased risk of compensated cirrhosis and hepatocellular carcinoma (HCC), [2,3] replication-suppressing antiviral therapy is administered to CHB patients to prevent liver disease progression.[4] As a matter of fact, oral antiviral agents, particularly entecavir (ETV), reduce the risk of long-term complications such as liver compensated cirrhosis and HCC, ultimately improving survivals compared to controls.
Source: Journal of Hepatology - Category: Gastroenterology Authors: Source Type: research
Chronic hepatitis B (CHB) is the most common chronic viral infection worldwide, affecting approximately 350 million people.1 Because persistently high hepatitis B virus (HBV) replication is associated with an increased risk of compensated cirrhosis and hepatocellular carcinoma (HCC),2,3 replication-suppressing antiviral therapy is administered to patients with CHB to prevent liver-disease progression.4 As a matter of fact, oral antiviral agents, particularly entecavir (ETV), reduce the risk of long-term complications such as cirrhosis and HCC, ultimately improving survival compared to controls.
Source: Journal of Hepatology - Category: Gastroenterology Authors: Tags: Research Article Source Type: research
AbstractBackground and aimMac-2-binding protein glycosylation isomer (M2BPGi) is a novel serum diagnostic marker for liver fibrosis in various liver diseases. We aimed to evaluate its role in assessment of liver fibrosis in chronic hepatitis B infection (CHB) with reference to liver stiffness measurement (LSM).MethodsCHB patients with LSM by transient elastography technology and retrievable serum samples were recruited. Ten-year re-assessments of LSM and M2BPGi were repeated in a patient subgroup.Results240 CHB patients (M:F  = 116:124; median age 47.5 years) were recruited. The median M2BPGi values for ...
Source: Hepatology International - Category: Infectious Diseases Source Type: research
Publication date: December 2011Source: Digestive and Liver Disease Supplements, Volume 5, Issue 1Author(s): Martín Prieto, María García-ElizAbstractLiver transplantation remains the ultimate cure for patients with hepatitis B virus-related end-stage liver disease. Clinical Practice Guidelines currently recommend that patients with decompensated HBV cirrhosis should be treated without delay with nucleos(t)ide analogues regardless of the patient's serum ALT, HBV DNA level, and HBeAg status. The main goal of pre-transplantation antiviral therapy is to achieve a rapid and prolonged suppression of viral rep...
Source: Digestive and Liver Disease Supplements - Category: Gastroenterology Source Type: research
Authors: Béguelin C, Fall F, Seydi M, Wandeler G Abstract INTRODUCTION: Hepatitis B virus (HBV) infection is the most important cause of hepatocellular carcinoma in sub-Saharan Africa (SSA). Although the tools to curb the epidemic are known, only a minority of HBV-infected persons are currently diagnosed and treated. Areas covered: We discuss HBV epidemiological trends in SSA, describe important determinants of its natural history, and summarize current knowledge on the continuum of HBV care. Using the results of a systematic review of the literature, we describe the proportion of patients with liver fibrosi...
Source: Expert Review of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research
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