In patients with HBeAg-positive chronic hepatitis B, peginterferon alfa-2a offers superior efficacy over lamivudine, on the basis of HBeAg seroconversion, HBV DNA suppression, and HBsAg seroconversion.

Large volume of new data on the natural history and treatment of chronic hepatitis B virus (HBV) infection have become available since 2008. These include further studies in asymptomatic subjects with chronic HBV infection and community-based cohorts, the role of HBV genotype/naturally occurring HBV mutations, the application of non-invasive assessment of hepatic fibrosis and quantitation of HBV surface antigen and new drug or new strategies towards more effective therapy. To update HBV management guidelines, relevant new data were reviewed and assessed by experts from the region, and the significance of the reported findings was discussed and debated. The earlier "Asian-Pacific consensus statement on the management of chronic hepatitis B" was revised accordingly. The key terms used in the statement were also defined. The new guidelines include general management, indications for fibrosis assessment, time to start or stop drug therapy, choice of drug to initiate therapy, when and how to monitor the patients during and after stopping drug therapy. Recommendations on the therapy of patients in special circumstances, including women in childbearing age, patients with antiviral drug resistance, concurrent viral infection, hepatic decompensation, patients receiving immune suppression or chemotherapy and patients in the setting of liver transplantation and hepatocellular carcinoma, are also included.

T he goal of therapy in patients with chronic hepatitis B is the prevention of cirrhosis, hepatocellular carcinoma, and hepatitis B virus (HBV)-related mortality. 1 However, it is difficult to assess these outcomes during short-term clinical trials because of the prolonged natural history of chronic hepatitis B. Surrogate endpoints are used for assessing the efficacy of anti-HBV drugs. Reduction in hepatitis B virus deoxyribonucleic acid (HBV DNA) is an excellent measure of antiviral efficacy. However, a decrease in HBV DNA Abbreviations: HBeAg, hepatitis B e antigen; HBV, hepatitis B virus; NPV, negative predictive value. From the

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