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hepatitis b treatment guidelines

Seung Man Cho, Byung-Ho Choe
This review article was requested by editor-in-chief of this journal as 'pediatric CHB treatment' for the upcoming special issue. The main objective of chronic hepatitis B (CHB) treatment is diminishing the risk of complications related to chronic liver disease. In Asia, there are already some reports about hepatocellular carcinoma (HCC) in hepatitis B virus (HBV) infected children. The key points of treatment in children with CHB infections are selection of which patients to treat and conformation of the optimal therapy time that would reduce viral resistance...
September 2016: Annals of Translational Medicine
Sheikh Mohammad Fazle Akbar, Mamun Al-Mahtab, Md Sakilur Islam Khan, Ruksana Raihan, Ananta Shrestha
Although several antiviral drugs are now available for treatment of patients with chronic hepatitis B (CHB), sustained off-treatment clinical responses and containment of CHB-related complications are not achieved in majority of CHB patients by antiviral therapy. In addition, use of these drugs is endowed with substantial long term risk of viral resistance and drug toxicity. The infinite treatment regimens of antiviral drugs for CHB patients are also costly and usually unbearable by most patients of developing and resource-constrained countries...
September 2016: Annals of Translational Medicine
Imane El Dika, James J Harding, Ghassan K Abou-Alfa
PURPOSE OF REVIEW: Hepatocellular carcinoma (HCC) is becoming an important cause of mortality in patients with HIV, attributed to coinfection with hepatitis C virus, hepatitis B virus, and the longer survival advantage these patients are achieving after introducing the highly active antiretroviral therapy (HAART) regimens. RECENT FINDINGS: In addition to hepatitis infection, immunosuppression secondary to HIV infection, direct impact of the virus on liver parenchyma, and the use of hepatotoxic antiretroviral drugs, all contribute to HCC pathogenesis...
October 15, 2016: Current Opinion in HIV and AIDS
Gamze Ugurluer, Robert C Miller, Yexiong Li, Juliette Thariat, Pirus Ghadjar, Ulrike Schick, Mahmut Ozsahin
Primary hepatic lymphoma (PHL) is a rare malignancy. We aimed to assess the clinical profile, outcome and prognostic factors in PHL through the Rare Cancer Network (RCN). A retrospective analysis of 41 patients was performed. Median age was 62 years (range, 23-86 years) with a male-to-female ratio of 1.9:1.0. Abdominal pain or discomfort was the most common presenting symptom. Regarding B-symptoms, 19.5% of patients had fever, 17.1% weight loss, and 9.8% night sweats. The most common radiological presentation was multiple lesions...
September 5, 2016: Rare Tumors
A G Spruijt, K R Wilting, G D Mithoe, W J M Niessen
OBJECTIVE: To investigate the effect of an intervention in which medical-microbiological laboratories alert general practitioners (GPs) in writing about patients with a chronic hepatitis B or C infection in their practice, urging them to bring these patients under medical surveillance again now that treatment options have improved and guidelines have been revised. DESIGN: Descriptive, prospective. METHOD: All patients who had been diagnosed with hepatitis B or C between 2003 and 2013 on the request of the GP, and for whom diagnostics by an internist, infectious diseases specialist or gastrointestinal/liver specialist had never been requested, were included...
2016: Nederlands Tijdschrift Voor Geneeskunde
H Becker, J T Stahmeyer, M P Manns, C Krauth, M Cornberg
Infections with hepatitis B-, C- and D- viruses have a significant health burden. In Germany, the seroprevalence of HBs-Ag is calculated with 0.6 % and of HCV-antibodies with 0.3 %. However, most patients are not diagnosed. Sequelae are liver-cirrhosis and hepatocellular carcinoma. Several S3-guidelines for the diagnosis and treatment of viral hepatitis have been established. However, implementation of guidelines is not easy to evaluate. To estimate the changes of medical knowledge and diagnostic procedures about viral hepatitis, 7 parameters of liver-diagnostics were elected to analyze the requirements profile in the years 2005 - 2011 in 4 German federal states...
October 6, 2016: Zeitschrift Für Gastroenterologie
Ömer Karadağ, Timuçin Kaşifoğlu, Birol Özer, Sabahattin Kaymakoğlu, Yeşim Kuş, Murat İnanç, Gökhan Keser, Sedat Kiraz
Biological drugs (tumor necrosis factor inhibitors, rituximab, tocilizumab, abatacept, and tofacitinib) are important treatment alternatives in rheumatology, particularly for resistant patients. However, they may cause hepatitis B virus (HBV) and hepatitis C virus (HCV) reactivation; for instance, HBV reactivation may occur in a patient who is an inactive hepatitis B surface antigen (HBsAg) carrier or who has resolved HBV infection. Therefore, the screening of patients before biological treatment and the application of a prophylactic treatment, particularly with respect to latent HBV infections, are recommended when necessary...
March 2016: Eur J Rheumatol
Valter Oberdan Borges de Oliveira, Juliana Passos Rocha Oliveira, Eloy Vianey Carvalho de França, Hugo Leite de Farias Brito, Tereza Virgínia Nascimento, Alex França
Introduction: According to the guidelines, the viral load of 2,000 IU/mL is considered the level to differentiate between inactive carriers and HBeAg(-) chronic hepatitis B patients. Even so, liver damage may be present in patients with lower viral load levels, mainly related to regional variations. This study aims to verify the presence of liver injury in patients with viral load below 2,000 IU/mL. Methods: Patients presenting HBsAg(+) for more than six months, Anti-HBe(+)/HBeAg(-), viral load below 2,000 IU/mL and serum ALT levels less than twice the upper limit of normality underwent liver biopsy...
2016: Revista do Instituto de Medicina Tropical de São Paulo
Teerapat Ungtrakul, Chulabhorn Mahidol, Pattra Chun-On, Charlie Laohapand, Surachate Siripongsakun, Akeanong Worakitsitisatorn, Sirachat Vidhayakorn, Wariya Boonchuay, Jiraporn Dechma, Gaidganok Sornsamdang, Kamonwan Soonklang, Tassanee Sriprayoon, Tawesak Tanwandee, Chirayu U Auewarakul
AIM: To determine the role of screening and surveillance of hepatocellular carcinoma (HCC) in treatment-naïve chronic hepatitis B (CHB) patients. METHODS: We recruited 2293 CHB patients (both males and females; aged 20-65 years). All patients were screened and underwent surveillance using abdominal ultrasonography (AUS) and serum alpha-fetoprotein (AFP) assay every 6 mo. The diagnosis, staging and treatment of HCC followed the American Association for the Study of Liver Diseases practice guidelines and the Barcelona Clinic Liver Cancer guidelines...
September 14, 2016: World Journal of Gastroenterology: WJG
R J Wong, M T Nguyen, H N Trinh, A Huynh, M T Ly, H A Nguyen, K K Nguyen, J Yang, R T Garcia, B Levitt, E da Silveira, R G Gish
Sofosbuvir/ledipasvir (SOF/LDV) is the first all-oral ribavirin-free treatment approved for chronic hepatitis C virus (HCV) genotype 6, offering a safe and highly efficacious treatment option. Large studies evaluating real-world outcomes of this regimen are lacking. We aim to evaluate real-world treatment outcomes for HCV genotype 6. A retrospective cohort study evaluated 65 adults (age ≥18) with chronic HCV genotype 6 treated with SOF/LDV without ribavirin at a community gastroenterology clinic in the United States from November 2014 to May 2016...
September 27, 2016: Journal of Viral Hepatitis
Yolanda Braun-Moscovici, Marius Braun, Tarek Saadi, Doron Markovits, Menahem A Nahir, Alexandra Balbir-Gurman
BACKGROUND: Immunosuppressive agents may induce hepatitis B flares. The minimal corticosteroid dose and duration of therapy leading to HBV reactivation is unknown. OBJECTIVE: To assess whether short-term corticosteroid therapy for rheumatologic diseases induces HBV reactivation. METHODS: The records of all HBsAg or HBcore antibodies positive, anti-HBs negative patients who were hospitalized in the rheumatology department during 2001-2014 and treated with corticosteroids were reviewed...
October 2016: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Atsushi Tanaka, Xiong Ma, Osamu Yokosuka, Martin Weltman, Hong You, Deepak N Amarapurkar, Yoon Jun Kim, Zaigham Abbas, Diana A Payawal, Ming-Ling Chang, Cumali Efe, Ersan Ozaslan, Masanori Abe, Robert Mitchell-Thain, Mikio Zeniya, Kwang Hyub Han, John M Vierling, Hajime Takikawa
During the 25th annual meeting of the Asia-Pacific Association for the Study of the Liver (APASL 2016) in Tokyo, we organized and moderated an inaugural satellite symposium on the autoimmune liver diseases, autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC). Following the keynote lecture by John M. Vierling (USA), speakers from the Asia-Pacific region provided an up-to-date perspective on the epidemiology, clinical practice and research in AIH and PBC in the Asia-Pacific region. Although epidemiology and clinical features of AIH seem to be similar in East Asia compared to those in western countries, the majority of patients with AIH are detected at an advanced stage and have higher mortality rates in South Asia, indicating an unmet need for earlier diagnosis and the initiation of appropriate immunosuppressive treatment...
September 20, 2016: Hepatology International
Nicholas Petersdorf, Jennifer M Ross, Helen A Weiss, Ruanne V Barnabas, Judith N Wasserheit
INTRODUCTION: Hepatitis C virus (HCV) and HIV infection frequently co-occur due to shared transmission routes. Co-infection is associated with higher HCV viral load (VL), but less is known about the effect of HCV infection on HIV VL and risk of onward transmission. METHODS: We undertook a systematic review comparing 1) HIV VL among ART-naïve, HCV co-infected individuals versus HIV mono-infected individuals and 2) HIV VL among treated versus untreated HCV co-infected individuals...
2016: Journal of the International AIDS Society
Pongphob Intaraprasong, Sith Siramolpiwat, Ratha-Korn Vilaichone
Hepatocellular carcinoma (HCC) is the most frequent type of malignant liver tumor and a high impact health problem worldwide. The prevalence of HCC is particularly high in many Asian and African countries. Some HCC patients have no symptoms prior to diagnosis and many of them therefore present at late stage and have a grave prognosis. The well-established causes of HCC are chronic hepatitis B virus (HBV) or chronic hepatitis C virus (HCV) infection or alcoholic cirrhosis and nonalcoholic steatohepatitis. The Barcelona Clinic Liver Cancer (BCLC) Staging System remains the most widely used for HCC management guidelines...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
Philippa J Easterbrook
Testing and diagnosis of hepatitis C virus (HCV) infection is the gateway for access to both treatment and prevention services, and crucial for an effective hepatitis epidemic response. In contrast to HIV, a systematic approach to hepatitis C testing has been fragmented and limited to a few countries, and there remains a large burden of undiagnosed cases globally. Key challenges in the current hepatitis testing response, include lack of simple, reliable, and low cost diagnostic tests, laboratory capacity, and testing facilities; inadequate data to guide country-specific hepatitis testing approaches and who to test; stigmatization and social marginalization of some groups with or at risk of viral hepatitis; and lack of international or national guidelines on hepatitis testing for resource-limited settings...
October 2016: Journal of Hepatology
P R Spradling, J Xing, L B Rupp, A C Moorman, S C Gordon, E T Teshale, M Lu, J A Boscarino, M A Schmidt, C M Trinacty, S D Holmberg
BACKGROUND: Limited information exists regarding the distribution of disease phases, treatment prescription and severe liver disease among patients with chronic hepatitis B (CHB) in US general healthcare settings. AIM: To determine the distribution of disease phases, treatment prescription and severe liver disease among patients with CHB in general US healthcare settings. METHODS: We analysed demographic and clinical data collected during 2006-2013 from patients with confirmed CHB in the Chronic Hepatitis Cohort Study, an observational cohort study involving patients from healthcare organisations in Michigan, Pennsylvania, Oregon and Hawaii...
November 2016: Alimentary Pharmacology & Therapeutics
R Flisiak, E Janczewska, M Wawrzynowicz-Syczewska, J Jaroszewicz, D Zarębska-Michaluk, K Nazzal, B Bolewska, J Bialkowska, H Berak, K Fleischer-Stępniewska, K Tomasiewicz, K Karwowska, K Rostkowska, A Piekarska, O Tronina, G Madej, A Garlicki, M Lucejko, A Pisula, E Karpińska, W Kryczka, A Wiercińska-Drapało, I Mozer-Lisewska, M Jabłkowski, A Horban, B Knysz, M Tudrujek, W Halota, K Simon
BACKGROUND: Virologic and safety outcomes of ombitasvir/paritaprevir/ritonavir ± dasabuvir ± ribavirin (OBV/PTV/r ± DSV ± RBV) therapy have shown high sustained virologic response (SVR) rates and good tolerability in most patient populations in pre-registration studies. AIM: To confirm these clinical trial findings in the treatment of genotype 1 and 4 hepatitis C under real-world conditions. METHODS: Patients enrolled for treatment with OBV/PTV/r ± DSV ± RBV based on therapeutic guidelines were included, and the regimen was administered according to product characteristics...
November 2016: Alimentary Pharmacology & Therapeutics
Deepak N Amarapurkar, Kaushal Madan, Dharmesh Kapoor
Chronic hepatitis B (CHB) infection is a substantial global health problem with highest prevalence observed in the sub-Saharan Africa and East Asia. India lies in the intermediate endemicity zone with prevalence ranging from 0.1% to 11.7%. The predominant route of transmission is horizontal and the most commonly occurring genotypes are A and D. The high mortality and morbidity associated with CHB constitutes significant health and economic burden in developing countries like India. Antiviral agents decrease HBV DNA load and prevent disease progression...
November 2015: Journal of the Association of Physicians of India
Man Fai Law, Rita Ho, Carmen K M Cheung, Lydia H P Tam, Karen Ma, Kent C Y So, Bonaventure Ip, Jacqueline So, Jennifer Lai, Joyce Ng, Tommy H C Tam
Hepatitis due to hepatitis B virus (HBV) reactivation can be severe and potentially fatal, but is preventable. HBV reactivation is most commonly reported in patients receiving cancer chemotherapy, especially rituximab-containing therapy for hematological malignancies and those receiving stem cell transplantation. All patients with hematological malignancies receiving anticancer therapy should be screened for active or resolved HBV infection by blood tests for hepatitis B surface antigen (HBsAg) and antibody to hepatitis B core antigen (anti-HBc)...
July 28, 2016: World Journal of Gastroenterology: WJG
Yoshiki Hiraki, Akira Kawano, Hirohisa Shigematsu, Koichiro Miki, Hideyuki Nomura, Shinji Shimoda
A 63-year-old female and a 63-year-old male with resolved HBV infection suffered a relapse of malignant lymphoma. After bendamustine hydrochloride monotherapy, HBV reactivation occurred. Entecavir treatment was commenced immediately, with tests for HBV DNA negative without development of hepatitis. Regular monitoring of HBV DNA based on the guidelines from the Japan Society of Hepatology was useful.
September 2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
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