Improvements in the Management of Chronic Hepatitis B Virus Infection
Lucas Zhihong Liu, Jian Sun, Jinlin Hou & Henry Lik Yuen Chan
Received 10 Aug 2018, Accepted 28 Sep 2018, Accepted author version posted online: 29 Sep 2018
Introduction: The primary goals of managing chronic hepatitis B (CHB) are prevention of liver-related complications and reduction of mortality. Universal vaccination has dramatically reduced the incidence of new infection, but the management of existing CHB patients are still challenging.
Areas covered: This review compares the similarities and differences among the latest published regional guidelines on the indications and choices of antiviral therapy. We have summarized advances in virological biomarkers and non-invasive tests for liver fibrosis in disease assessment. Benefits and remaining challenges of current standard of care by peginterferon and nucleos(t)ide analogues (NA) have been presented . Data on combination therapy of peginterferon and NA in seeking functional cure of the disease is also critically discussed. We have also described the improvement in the management of CHB at pregnancy and prophylaxis in patients on chemotherapy and immunosuppressants.
Expert commentary: Controversies exist in the assessment of disease activity for selection patients for treatment as well as on the use of tenofovir alafenamide as a safe and cost-effective alternative to tenofovir disoproxil fumarate. Though combination therapy of peginterferon and NA has induced HBsAg seroclearance in a small proportion of patients, peginterferon is not preferred in the future trend of drug development.
Keywords: Peginterferon, Entecavir, Tenofovir, Cirrhosis, Hepatocellular Carcinoma, Fibroscan, HBsAg, Functional Cure作者: StephenW 时间: 2018-9-30 20:02
慢性乙型肝炎病毒感染管理的改进
Lucas Zhihong Liu，孙建，侯金林，Henry Lik Yuen Chan
收稿日期2018年8月10日，接受2018年9月28日，接受作者发布于2018年9月29日