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Improvements in the management of chronic hepatitis B virus infection

Lucas Zhihong Liu1, Jian Sun1, Jinlin Hou1

  • 1a Department of Infectious Diseases, Nanfang Hospital , Southern Medical University , Guangzhou , China.

Expert Review of Gastroenterology & Hepatology
|October 2, 2018
PubMed

Insights

This review compares global guidelines for chronic hepatitis B (CHB) antiviral therapy, highlighting new biomarkers and treatment strategies. Current therapies offer benefits but challenges remain in achieving a functional cure for CHB.

Area of Science:

  • Hepatology
  • Virology
  • Immunology

Background:

  • Chronic hepatitis B (CHB) management aims to prevent liver complications and reduce mortality.
  • While universal vaccination reduced new infections, managing existing CHB patients remains challenging.
  • This review focuses on current antiviral therapy guidelines and disease assessment advancements.

Purpose of the Study:

  • To compare international guidelines on CHB antiviral therapy indications and choices.
  • To summarize advances in virological biomarkers and non-invasive liver fibrosis tests.
  • To critically discuss combination therapy for functional cure and management improvements.

Main Methods:

  • Comparative analysis of recent regional CHB management guidelines.
  • Review of literature on virological biomarkers and non-invasive fibrosis tests.
  • Evaluation of current standard treatments (peginterferon, nucleos(t)ide analogs) and combination therapies.

Main Results:

  • Guidelines show variations in treatment indications and antiviral choices.
  • New biomarkers and non-invasive tests improve disease assessment.
  • Peginterferon and nucleos(t)ide analog combination therapy shows potential for HBsAg seroclearance but faces challenges.

Conclusions:

  • Controversies persist regarding treatment assessment and specific drug choices (e.g., tenofovir alafenamide vs. tenofovir disoproxil fumarate).
  • While combination therapy may induce HBsAg seroclearance, peginterferon is not a primary focus for future drug development.
  • Improved management strategies are noted for CHB in pregnancy and prophylaxis during chemotherapy.
Abstract

Keywords:
HBsAgPeginterferoncirrhosisentecavirfibroscanfunctional curehepatocellular carcinomatenofovir

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