Hepatology International

, Volume 7, Issue 2, pp 451–459

Are physicians following guidelines? A survey of Hepatitis B management strategies

Original Article

DOI: 10.1007/s12072-012-9399-7

Cite this article as:
Lee, K.H., Aung, M.O. & Lim, S.G. Hepatol Int (2013) 7: 451. doi:10.1007/s12072-012-9399-7



Practice guidelines for chronic hepatitis B (CHB) assist physicians in management; however, there are also areas where they provide no guidance. This paper aimed to examine treatment preferences for CHB among physicians based upon the Asia Pacific Association for the Study of the Liver (APASL) consensus guidelines 2008.


A questionnaire was prepared consisting of 18 questions grouped into 8 sections: basic information of participants, the proportion and number of CHB patients on treatment, case scenarios of treatment initiation, preferences for antiviral therapy, scenarios for stopping and continuing antiviral therapy, monitoring patients during therapy, and viral resistance management. The questionnaire was introduced to the APASL 2009 conference delegates.


A total of 508 participants from 34 countries participated in the survey. Lamivudine or peg-interferon monotherapy was the preferred first-line therapy, while lamivudine/adefovir combination was the drug of choice for rescue therapy. Drug efficacy and cost were the most important factors to consider before initiating treatment, while viral resistance had a low priority. In general, the APASL guideline was strictly followed in about 50–60 % of the scenarios (initiating, stopping, or continuing antiviral therapy).


The survey concluded that clinical management preferences differed from APASL guidelines in many instances.


Chronic hepatitis BManagementAPASL guidelinesQuestionnaire

Copyright information

© Asian Pacific Association for the Study of the Liver 2012

Authors and Affiliations

  • Keat Hong Lee
    • 1
  • Myat Oo Aung
    • 1
  • Seng Gee Lim
    • 1
    • 2
    • 3
  1. 1.Department of Gastroenterology and HepatologyNational University Hospital, National University Health SystemBuona VistaSingapore
  2. 2.Department of Medicine, Yong Loo Lin School of MedicineNational University of SingaporeBuona VistaSingapore
  3. 3.Department of Gastroenterology and HepatologyNational University HospitalBuona VistaSingapore