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Chronic Hepatitis B Virus Infection: Disease Revisit and Management Recommendations.
Man-Fung Yuen1, Sang Hoon Ahn, Ding-Shinn Chen
1*Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong†Department of Internal Medicine, Yonsei University College of Medicine, Brain Korea 21 Project for Medical Science, Seoul, South Korea‡Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan§Royal Free and University College, School of Medicine, London, UK∥Hepatology Unit and Key Laboratory for Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China¶Southwestern Medical Center, University of Texas, Dallas, TX#The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Ichikawa, Japan**INSERM Unité 1052, Cancer Research Center of Lyon, Lyon University, Lyon, France.
Chronic hepatitis B (HBV) infection can lead to cirrhosis and liver cancer. Antiviral treatments like entecavir and tenofovir suppress HBV DNA, reducing complications and potentially reversing liver damage.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Chronic hepatitis B virus (HBV) infection progresses through distinct phases, potentially leading to cirrhosis and hepatocellular carcinoma (HCC).
- Host and viral factors influence disease progression and complication development.
- Risk scores for HCC development have been established.
Purpose of the Study:
- To outline current treatment guidelines for chronic HBV infection.
- To review the efficacy and outcomes of antiviral therapies.
- To discuss monitoring strategies and future therapeutic directions.
Main Methods:
- Review of clinical guidelines and published literature on chronic HBV management.
- Analysis of factors associated with HBV-related complications.
- Evaluation of nucleos(t)ide analog (NA) efficacy in reducing viral load, fibrosis, and HCC.
Main Results:
- Treatment is recommended for patients with elevated alanine aminotransferase and HBV DNA levels, or with established cirrhosis and detectable HBV DNA.
- First-line treatments include pegylated interferon, entecavir, and tenofovir.
- Long-term NA therapy effectively suppresses HBV DNA, decreases fibrosis, may reverse cirrhosis, and reduces HCC incidence with low resistance rates.
Conclusions:
- Long-term nucleos(t)ide analog therapy is crucial for managing chronic HBV, suppressing viral replication, and preventing severe liver disease.
- Hepatitis B surface antigen (HBsAg) seroclearance remains an achievable but infrequent endpoint.
- Ongoing research aims to develop novel agents to improve HBsAg seroclearance rates and enhance treatment outcomes.
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