Chronic hepatitis B

Abstract

PREAMBLEThese guidelines have been written to assist physicians and other health care providers in the recognition, diagnosis, and management of patients chronically infected with the hepatitis B virus (HBV). They are intended to suggest preferable approaches to the clinical management of chronic hepatitis B. The recommendations are flexible and are not intended as the only acceptable approach to management and treatment. As the appropriate course of treatment will vary in light of the relevant facts and circumstances surrounding each individual patient with chronic hepatitis B, guidelines are not intended to define the applicable standard of medical care and may be updated periodically as new information becomes available.These guidelines were developed under the auspices of, and approved by, the Practice Guidelines Committee of the American Association for the Study of Liver Diseases. They should be taken as guidelines and not "standards of care." Data used to support the recommendations made were obtained by a literature search of peer-reviewed articles concerning the natural history, diagnosis, and treatment of chronic hepatitis B. In addition, the proceedings of a recent National Institutes of Health workshop on the "Management of Hepatitis B" were considered in the development of these guidelines. 1 The strength of each recommendation is categorized based on the quality of evidence in the literature according to the rating system indicated in Table 1. 2

Economic analysis of the first 20 years of universal hepatitis B vaccination program in Italy

“…Instead, decompensated cirrhosis patients have a survival rate of 14% after 5 y from the onset. 15,20,26 The survival rate of hepatocellular carcinoma cases was obtained by Santi et al, and corresponds to 78.7%, 50.4% and 28.9%, at 1, 3 and 5 y, respectively. 27 Five percent of patients requiring liver transplantation encounters transplant-related operative death, while the others have a 72% post-transplant survival rate 5 y after surgery.…”

“…4). [11][12][13][14][15][16][17][18][19] Ninety percent of those with chronic infection undergo spontaneous anti-HBe seroconversion. Twenty percent of those who seroconverted revert to HBeAg positive.…”

Hepatitis B virus reactivation with rituximab-containing regimen

“…Recently, Huang et al [33] also reported the efficacy of the preventive administration of entecavir. Studies using lamivudine to treat HBV hepatitis have reported an annual increase of approximately 15%-20% in HBV lamivudine resistance [45,46] , indicating the problem of the emergence of drug-resistant HBV strains during preventive lamivudine administration. Pelizzari et al [47] , however, showed that for lamivudine treatment during chemotherapy for hematological malignancies, the frequency of drug resistance may be lower than what was seen in hepatitis B treatment, suggesting that long-term lamivudine treatment might be possible.…”

“…In evaluating methods to predict HBV reactivation, HBV-DNA monitoring alone is insufficient and other pieces of information, such as shifts in the anti-HB titer levels (before and during the rituximab treatment), should be utilized to assist the early detection of HBV reactivation. Preventive nucleoside analog against HBV is currently recommended for 4-6 mo after chemotherapy completion [46,50,52,61] . However, reports of HBV reactivation 4 to 6 mo after chemotherapy [62][63][64][65] suggest that this number should be revised.…”

A prospective study of hepatitis B virus markers in patients with chronic HBV infection from Brazilian families of Western and Asian origin

“…As discussed below, this prevalence also varies within countries from region to region, depending on different factors, such as socioeconomic conditions, the extent of drug addiction, the extent of alcoholism, professional blood donation, homosexual behavior, and there is also a high familial incidence (3).…”