Practical management of chronic hepatitis B infection

Chronic hepatitis B virus (HBV) infection is a complex disease. In recent years, there has been a marked increase in new knowledge regarding its virology, epidemiology, and natural history. In addition, more sensitive molecular diagnostic tests and relatively effective therapies for many individuals with chronic HBV infection have been developed and are available to practicing physicians. On the other hand, the influx of new immigrants from HBV hyperendemic areas such as the Asia-Pacific region, Indochina, and Eastern Europe has increased the demand for management of HBV infection in these populations. Physicians thus need to be able to identify persons at risk for hepatitis B and to evaluate and monitor them appropriately. Counseling on precautions to prevent transmission of HBV is also important for patients, as is education regarding the natural course of HBV infection and patient prognosis. Clinicians need to balance the treatment options carefully for their patients. This article provides up-to-date information on management of HBV infection for practicing physicians.