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Chronic Hepatitis B.

Norah A. Terrault1

  • 1Division of Gastroenterology, Department of Internal Medicine, University of California, San Francisco, 513 Parnassus Avenue, S357, San Francisco, CA 94143-0538, USA. noraht@itsa.ucsf.edu

Current Treatment Options in Gastroenterology
|November 7, 2001
PubMed
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Evaluating hepatitis B virus (HBV) infection requires assessing disease activity, liver function, and viral replication. Treatment decisions for chronic HBV depend on disease severity and viral load, with individualized therapy recommended.

Area of Science:

  • Hepatology
  • Virology
  • Internal Medicine

Background:

  • Hepatitis B virus (HBV) surface antigen (HBsAg) positive patients require comprehensive evaluation.
  • Understanding infection activity, severity, and replication is crucial for management.

Purpose of the Study:

  • To outline the diagnostic and therapeutic strategies for managing hepatitis B virus infection.
  • To guide the selection of antiviral therapies based on disease characteristics.

Main Methods:

  • Assessment includes liver enzymes, function tests, viral markers (HBV DNA, HBeAg, anti-HBe), and ultrasound.
  • Liver biopsy is recommended for staging fibrosis and determining therapy urgency in cases of abnormal liver enzymes.
  • Evaluation of current antiviral therapies (interferon alfa, lamivudine) and their indications.

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Main Results:

  • Patients with abnormal liver enzymes and active replication (HBV DNA positive) with compensated disease are candidates for interferon or lamivudine.
  • Lamivudine is the preferred treatment for patients with decompensated liver disease and active replication, with liver transplantation referral considered.
  • New antiviral agents and combination therapies are under investigation to improve efficacy and reduce resistance.

Conclusions:

  • Individualized treatment approaches are essential for chronic HBV infection.
  • Therapeutic strategies should consider patient comorbidities, prior treatment responses, and disease stage.
  • Advancements in antiviral therapies, including combination treatments, are expected to enhance outcomes for chronic HBV patients.