[Hepatitis B: who should be treated?].

Area of Science:

• Hepatology
• Virology
• Immunology

Context:

• Chronic hepatitis B (HBV) with active viral replication requires tailored management strategies.
• Coinfections with Hepatitis Delta Virus (HDV), Hepatitis C Virus (HCV), and Human Immunodeficiency Virus (HIV) complicate HBV treatment.
• Specific patient groups, including immunocompromised individuals and older adults with acute HBV, warrant treatment considerations.

Purpose:

• To outline current management guidelines for chronic hepatitis B based on viral replication and coinfection status.
• To highlight the need for individualized treatment approaches in chronic hepatitis B.
• To address treatment recommendations for specific acute HBV infection scenarios.

Summary:

• Management strategies for moderate to severe chronic hepatitis B with active HBV replication must incorporate Hepatitis B e-antigen (HBeAg) status and the presence of coinfecting viruses (HDV, HCV, HIV).
• Treatment is also advised for immunocompromised patients and individuals over 60 with acute HBV infection.
• Current therapies for chronic hepatitis B demonstrate limited long-term effectiveness, necessitating careful consideration of patient age, disease severity, predicted treatment response, and potential adverse effects before initiating therapy.

Impact:

• Informs clinical decision-making for healthcare providers managing hepatitis B patients.
• Emphasizes the importance of personalized medicine in virology.
• Highlights the need for further research into more effective and durable treatments for chronic hepatitis B.