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Perspectives on current controversial issues in the management of chronic HBV infection

Yun-Fan Liaw1

  • 1Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 199, Tung Hwa North Road, Taipei, 105, Taiwan. liveryfl@gmail.com.

Journal of Gastroenterology
|September 2, 2022
PubMed

Insights

Current consensus on chronic hepatitis B virus (HBV) infection management faces challenges. This review examines controversial issues in HBV diagnosis and treatment, including alanine aminotransferase (ALT) limits and therapy duration.

Area of Science:

  • Hepatology
  • Virology
  • Clinical Medicine

Background:

  • Decades of research have established consensus on chronic hepatitis B virus (HBV) infection and its management.
  • Emerging challenges and debates question existing concepts and definitions in HBV care.

Purpose of the Study:

  • To review, assess, and discuss controversial issues in chronic hepatitis B management.
  • To clarify or resolve debates regarding HBV infection concepts and definitions based on scientific evidence.

Main Methods:

  • Review and critical assessment of scientific evidence related to controversial topics in HBV management.
  • In-depth discussion of pros and cons for each debated issue.

Main Results:

  • Debates include: alanine aminotransferase (ALT) upper limit of normal (laboratory-defined vs. fixed).
  • Nomenclature for chronic HBV infection phases (classical vs. EASL proposal).
  • Antiviral therapy indications (treating patients vs. treating HBV) and duration (finite vs. indefinite).
  • Retreatment decisions based on biochemical markers versus HBsAg/ALT kinetics.

Conclusions:

  • Clarification of controversial issues in chronic hepatitis B management is essential.
  • Evidence-based discussion aims to resolve debates and refine clinical practice guidelines for HBV infection.

Keywords:
Antiviral therapyChronic hepatitis BLiver cirrhosis

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