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Conference Paper: Management of chronic hepatitis B

TitleManagement of chronic hepatitis B
Authors
Issue Date2010
PublisherS. Karger AG,.
Citation
The 2011 Falk Symposium 174 on Gut and Liver, Beijing, China, 27-28 August 2010. In Gut and Liver, 2010, p. 95-101 How to Cite?
AbstractChronic hepatitis B affects 400 million people worldwide. The criteria for initiating and stopping treatment are still under debate in spite of well-established agents for its treatment. Hepatitis B virus (HBV) DNA level has been shown to be a major determinant for disease progression, and the development of complications of cirrhosis and hepatocellular carcinoma, which often occur after hepatitis B e antigen (HBeAg) seroconversion. The usually chosen level of alanine transaminase (ALT) for treatment initiation in various treatment guidelines is 2 times the upper limit of normal, but patients having ALT below this level are also at risk for the development of complications. Treatment should be started when HBV DNA levels are high (>2,000 IU/ml) and ALT levels are above upper limit of normal. Treatment should preferably be continued on a long-term basis for both HBeAg-positive and HBeAg-negative patients, until hepatitis B surface antigen seroconversion. The three first-line agents of treatment are interferon-α (IFN), entecavir (ETV) and tenofovir disoproxil fumarate (TDF). Pegylated IFN is given for a limited period of 48 weeks, but a majority of patients continue to have detectable HBV DNA after treatment, and it has not been proven to decrease the incidence of hepatocellular carcinoma. ETV and TDF are both very potent antiviral agents able to maintain HBV DNA negativity when given on a long-term basis. The development of resistance for both drugs is low (1.2% after 6 years with ETV and 0% after 3 years with TDF). There is also histologic evidence with ETV that long-term treatment can decrease necroinflammation and reverse fibrosis/cirrhosis.
DescriptionSession: Chronic Liver Failure - Clinical Aspects
This book is proceedings of Falk Symposium 174, August 2010
Persistent Identifierhttp://hdl.handle.net/10722/138438
ISBN
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLai, CLen_US
dc.contributor.authorYuen, MFen_US
dc.date.accessioned2011-08-26T14:53:55Z-
dc.date.available2011-08-26T14:53:55Z-
dc.date.issued2010en_US
dc.identifier.citationThe 2011 Falk Symposium 174 on Gut and Liver, Beijing, China, 27-28 August 2010. In Gut and Liver, 2010, p. 95-101en_US
dc.identifier.isbn978–3–8055–9672–5-
dc.identifier.urihttp://hdl.handle.net/10722/138438-
dc.descriptionSession: Chronic Liver Failure - Clinical Aspects-
dc.descriptionThis book is proceedings of Falk Symposium 174, August 2010-
dc.description.abstractChronic hepatitis B affects 400 million people worldwide. The criteria for initiating and stopping treatment are still under debate in spite of well-established agents for its treatment. Hepatitis B virus (HBV) DNA level has been shown to be a major determinant for disease progression, and the development of complications of cirrhosis and hepatocellular carcinoma, which often occur after hepatitis B e antigen (HBeAg) seroconversion. The usually chosen level of alanine transaminase (ALT) for treatment initiation in various treatment guidelines is 2 times the upper limit of normal, but patients having ALT below this level are also at risk for the development of complications. Treatment should be started when HBV DNA levels are high (>2,000 IU/ml) and ALT levels are above upper limit of normal. Treatment should preferably be continued on a long-term basis for both HBeAg-positive and HBeAg-negative patients, until hepatitis B surface antigen seroconversion. The three first-line agents of treatment are interferon-α (IFN), entecavir (ETV) and tenofovir disoproxil fumarate (TDF). Pegylated IFN is given for a limited period of 48 weeks, but a majority of patients continue to have detectable HBV DNA after treatment, and it has not been proven to decrease the incidence of hepatocellular carcinoma. ETV and TDF are both very potent antiviral agents able to maintain HBV DNA negativity when given on a long-term basis. The development of resistance for both drugs is low (1.2% after 6 years with ETV and 0% after 3 years with TDF). There is also histologic evidence with ETV that long-term treatment can decrease necroinflammation and reverse fibrosis/cirrhosis.-
dc.languageengen_US
dc.publisherS. Karger AG,.-
dc.relation.ispartofGut and Liver: Falk Symposium 174, Beijing, August 2010en_US
dc.titleManagement of chronic hepatitis Ben_US
dc.typeConference_Paperen_US
dc.identifier.emailLai, CL: hrmelcl@hku.hken_US
dc.identifier.emailYuen, MF: mfyuen@hku.hken_US
dc.identifier.authorityLai, CL=rp00314en_US
dc.identifier.authorityYuen, MF=rp00479en_US
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1159/000322457-
dc.identifier.hkuros190355en_US
dc.identifier.spage95en_US
dc.identifier.epage101en_US
dc.identifier.isiWOS:000293715500016-
dc.publisher.placeBasel, Switzerland-

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