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Article: The natural history and treatment of chronic hepatitis B: A critical evaluation of standard treatment criteria and end points

TitleThe natural history and treatment of chronic hepatitis B: A critical evaluation of standard treatment criteria and end points
Authors
Issue Date2007
PublisherAmerican College of Physicians. The Journal's web site is located at http://www.annals.org
Citation
Annals Of Internal Medicine, 2007, v. 147 n. 1, p. 58-61 How to Cite?
AbstractThe definite indications for the treatment of chronic hepatitis B are serum hepatitis B virus (HBV) DNA levels greater than 105 copies/mL and alanine aminotransferase (ALT) levels more than 2 times the upper limit of normal. If cirrhosis is present, an HBV DNA level greater than 105 copies/mL is the sole criterion for treatment. Treatment end points include hepatitis B e antigen (HBeAg) seroconversion for HBeAg-positive patients, reduction of HBV DNA levels to less than 105 copies/mL, and normalization of ALT values. These guidelines may apply to patients who acquire the hepatitis B infection during adolescence or adulthood but are less suitable for most hepatitis B carriers, who are infected in early life. Cirrhosis complications, including hepatocellular carcinoma, often occur in this latter group despite HBeAg seroconversion, HBV DNA levels less than 104 copies/mL, or ALT levels between 0.5 and 2 times the upper limit of normal. Therefore, HBeAg seroconversion may not be an adequate end point for these patients; the ideal treatment end points are permanent suppression of HBV DNA to levels undetectable by polymerase chain reaction and reduction of ALT levels to less than 0.5 times the upper limit of normal. © 2007 American College of Physicians.
Persistent Identifierhttp://hdl.handle.net/10722/163091
ISSN
2015 Impact Factor: 16.44
2015 SCImago Journal Rankings: 5.378
References

 

DC FieldValueLanguage
dc.contributor.authorLai, CLen_US
dc.contributor.authorYuen, MFen_US
dc.date.accessioned2012-09-05T05:27:28Z-
dc.date.available2012-09-05T05:27:28Z-
dc.date.issued2007en_US
dc.identifier.citationAnnals Of Internal Medicine, 2007, v. 147 n. 1, p. 58-61en_US
dc.identifier.issn0003-4819en_US
dc.identifier.urihttp://hdl.handle.net/10722/163091-
dc.description.abstractThe definite indications for the treatment of chronic hepatitis B are serum hepatitis B virus (HBV) DNA levels greater than 105 copies/mL and alanine aminotransferase (ALT) levels more than 2 times the upper limit of normal. If cirrhosis is present, an HBV DNA level greater than 105 copies/mL is the sole criterion for treatment. Treatment end points include hepatitis B e antigen (HBeAg) seroconversion for HBeAg-positive patients, reduction of HBV DNA levels to less than 105 copies/mL, and normalization of ALT values. These guidelines may apply to patients who acquire the hepatitis B infection during adolescence or adulthood but are less suitable for most hepatitis B carriers, who are infected in early life. Cirrhosis complications, including hepatocellular carcinoma, often occur in this latter group despite HBeAg seroconversion, HBV DNA levels less than 104 copies/mL, or ALT levels between 0.5 and 2 times the upper limit of normal. Therefore, HBeAg seroconversion may not be an adequate end point for these patients; the ideal treatment end points are permanent suppression of HBV DNA to levels undetectable by polymerase chain reaction and reduction of ALT levels to less than 0.5 times the upper limit of normal. © 2007 American College of Physicians.en_US
dc.languageengen_US
dc.publisherAmerican College of Physicians. The Journal's web site is located at http://www.annals.orgen_US
dc.relation.ispartofAnnals of Internal Medicineen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAge Factorsen_US
dc.subject.meshAlanine Transaminase - Blooden_US
dc.subject.meshAntiviral Agents - Adverse Effects - Therapeutic Useen_US
dc.subject.meshCarcinoma, Hepatocellular - Etiologyen_US
dc.subject.meshCarrier State - Drug Therapyen_US
dc.subject.meshDna, Viral - Blooden_US
dc.subject.meshHepatitis B E Antigens - Blooden_US
dc.subject.meshHepatitis B, Chronic - Drug Therapy - Enzymology - Immunologyen_US
dc.subject.meshHumansen_US
dc.subject.meshLiver Cirrhosis - Etiologyen_US
dc.subject.meshLiver Neoplasms - Etiologyen_US
dc.subject.meshPractice Guidelines As Topic - Standardsen_US
dc.titleThe natural history and treatment of chronic hepatitis B: A critical evaluation of standard treatment criteria and end pointsen_US
dc.typeArticleen_US
dc.identifier.emailLai, CL:hrmelcl@hku.hken_US
dc.identifier.emailYuen, MF:mfyuen@hkucc.hku.hken_US
dc.identifier.authorityLai, CL=rp00314en_US
dc.identifier.authorityYuen, MF=rp00479en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.7326/0003-4819-147-1-200707030-00010-
dc.identifier.pmid17606962-
dc.identifier.scopuseid_2-s2.0-34447259615en_US
dc.identifier.hkuros130657-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34447259615&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume147en_US
dc.identifier.issue1en_US
dc.identifier.spage58en_US
dc.identifier.epage61en_US
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridLai, CL=7403086396en_US
dc.identifier.scopusauthoridYuen, MF=7102031955en_US

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