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Updated: Dec 28, 2025

"Liver-on-a-Chip" Cultures of Primary Hepatocytes and Kupffer Cells for Hepatitis B Virus Infection
10:25

"Liver-on-a-Chip" Cultures of Primary Hepatocytes and Kupffer Cells for Hepatitis B Virus Infection

Published on: February 19, 2019

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Approach to the patient with chronic hepatitis B and decompensated cirrhosis

Mitchell L Shiffman1

  • 1Liver Institute of Virginia, Bon Secours Mercy Health, Richmond, VA, USA.

Liver International : Official Journal of the International Association for the Study of the Liver
|February 21, 2020
PubMed

Insights

Antiviral therapy is crucial for patients with chronic hepatitis B virus (HBV) and cirrhosis to prevent hepatic decompensation and reduce mortality. Early treatment improves outcomes, especially in decompensated cases and when co-existing liver conditions like non-alcoholic fatty liver disease are present.

Area of Science:

  • Hepatology
  • Virology
  • Gastroenterology

Background:

  • Chronic hepatitis B virus (HBV) infection can lead to progressive liver fibrosis, cirrhosis, and hepatocellular carcinoma.
  • Patients with HBV and cirrhosis face high mortality risks from hepatic decompensation without timely intervention.
  • Antiviral therapy is essential for managing chronic HBV, particularly in patients with cirrhosis, to prevent severe complications.

Purpose of the Study:

  • To emphasize the critical role of antiviral therapy in managing chronic hepatitis B virus (HBV) infection in patients with cirrhosis.
  • To highlight the benefits of initiating antiviral therapy in both compensated and decompensated cirrhotic HBV patients.
  • To discuss the implications of co-existent liver disorders, such as non-alcoholic fatty liver disease (NAFLD), in patients with chronic HBV and cirrhosis.

Main Methods:

  • The abstract discusses established clinical guidelines and therapeutic strategies for managing chronic HBV.
  • It reviews the impact of antiviral therapy on liver function, disease scores (CTP, MELD), and transplant outcomes.
  • The text synthesizes information on co-existing conditions and their influence on disease progression and treatment.

Main Results:

  • Antiviral therapy is indicated for all patients with cirrhosis, regardless of HBeAg status or ALT levels, to prevent decompensation.
  • Initiating antiviral therapy in decompensated cirrhosis improves liver function, CTP/MELD scores, and reduces mortality and transplant need.
  • Co-existent NAFLD in HBV patients with cirrhosis increases the risk of decompensation and liver transplantation.

Conclusions:

  • Antiviral therapy is a cornerstone in preventing hepatic decompensation and improving survival in chronic HBV patients with cirrhosis.
  • Management strategies must consider co-existing liver diseases like NAFLD, which can exacerbate risks.
  • Antiviral prophylaxis is effective in preventing HBV recurrence post-liver transplantation.

Keywords:
HBV DNAchronic hepatitis Bcirrhosisnon-alcoholic fatty liver disease

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